Home hospitalization for acute bacterial dermo-hypodermitis: seven years of experience

José Ramos, Serviço de Dermatologia, Hospital Garcia de Orta, EPE, Almada, Portugal Sandra Lucas, Unidade Hospitalização Domiciliária, Hospital Garcia de Orta, EPE, Almada. Portugal António Silva, Serviço de Dermatologia, Hospital Garcia de Orta, EPE, Almada, Portugal Ana Monteiro, Serviço de Dermatologia, Hospital Garcia de Orta, EPE, Almada, Portugal Diogo Cerejeira, Serviço de Dermatologia, Hospital Pedro Hispano, EPE, Matosinhos. Portugal Vitória Cunha, Unidade Hospitalização Domiciliária, Hospital Garcia de Orta, EPE, Almada, Portugal João Alves, Serviço de Dermatologia, Hospital Garcia de Orta, EPE, Almada, Portugal

Background: Home hospitalization (HH) is an alternative to conventional hospitalization, but literature data about bacterial skin infections treated in this setting is sparse. Objectives: The objective is to characterize the demographic and clinical features of the population admitted with acute bacterial dermo-hypodermitis (ABDH) in a HH unit; to evaluate if this model can be a safe alternative to hospital care; and to assess patients’ global satisfaction regarding their HH experience. Methods: Retrospective analysis of clinical data related to episodes of ABDH admitted to the HH unit of our institution in 7 years (2015-2022). A phone questionnaire was then applied for the evaluation of patients’ global satisfaction about HH. Results: We included 88 patients with a mean age of 66.6 years. Seventy-one (81%) were admitted directly from the emergency department and 16 (18%) from hospital wards. Forty-five (51%) had at least three associated comorbidities. Local complications occurred in 21 patients (24%) and systemic complications in 7 (8%). Eight patients (9%) were transferred back to hospital care during their HH and only 1 patient (1%) was readmitted after 3 months of discharge. The mean duration of HH was 13.8 days, and the mean duration of antibiotic treatment was 14.6 days. Regarding patients’ satisfaction, 41 participants (84%) rated home care with the maximum grade of satisfaction. For the participants with previous hospital stays (n = 39), 27 (69%) preferred HH to in-hospital care. Conclusion: This study suggests that, even though the population with ABDH admitted to HH is aged and has a high prevalence of comorbidities, HH is a safe and effective alternative to hospital care in the case of stable disease. It seems also to be associated with high rates of patient’ satisfaction.