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Hospitalization of older patients often leads to declines in functional status and high likelihood of rehospitalization. Researchers in Italy assessed the effectiveness of a physician-led home-hospitalization program for 101 patients (mean age, 81) who presented to an emergency department with acutely decompensated NYHA class III or IV heart failure.
Patients were randomized to home care or hospital care. At-home patients received care from a team that included physicians, nurses, physical therapists, social workers, and counselors. The team performed blood testing, echocardiography, arterial blood gas monitoring, blood transfusions, and central venous access, among other interventions. At 6 months, mortality was 15% in both groups; readmiss…