Home hospitalization as a safe and well-accepted new approach: a retrospective cross-sectional study at a level II hospital

João Pedro Valente, Pediatric Unit, Child and Youth Department, Hospital Professor Doutor Fernando Fonseca, E.P.E. Lisbon, Portugal
André Garrido, Pediatric Unit, Child and Youth Department; Pediatric Home Hospitalization Unit, Child and Youth Department, Unidade Local de Saúde Amadora/Sintra - Hospital Professor Doutor Fernando Fonseca, E.P.E. Lisbon, Portugal
Andreia Fiúza Ribeiro, Pediatric Unit, Child and Youth Department; Pediatric Home Hospitalization Unit, Child and Youth Department, Unidade Local de Saúde Amadora/Sintra - Hospital Professor Doutor Fernando Fonseca, E.P.E. Lisbon, Portugal
Guida Fernandes, Pediatric Unit, Child and Youth Department; Pediatric Home Hospitalization Unit, Child and Youth Department, Unidade Local de Saúde Amadora/Sintra - Hospital Professor Doutor Fernando Fonseca, E.P.E. Lisbon, Portugal
Helena Ribeiro da Silva, Pediatric Unit, Child and Youth Department; Pediatric Home Hospitalization Unit, Child and Youth Department, Unidade Local de Saúde Amadora/Sintra - Hospital Professor Doutor Fernando Fonseca, E.P.E. Lisbon, Portugal
Helena Cristina Loureiro, Pediatric Unit, Child and Youth Department; Pediatric Home Hospitalization Unit, Child and Youth Department, Unidade Local de Saúde Amadora/Sintra - Hospital Professor Doutor Fernando Fonseca, E.P.E. Lisbon, Portugal

Introduction and Objectives: Pediatric home hospitalization (PHH) is a promising alternative to conventional inpatient care for selected acute pediatric conditions. This study aims to describe our first year of experience and to evaluate the safety, efficacy, and quality of care provided by the Pediatric Home Hospitalization Unit (PHHU) in a level II hospital in Lisbon. Methods: A retrospective cross-sectional study was conducted, including all patients admitted to the PHHU between June 2023 and May 2024. Data was obtained from clinical records and from caregiver satisfaction surveys administered prior to admission and following discharge. Statistical analyses were performed using IBM SPSS Statistics software (version 29.0.0, IBM Corp., Armonk, NY, USA). Results: There was a total of 211 admissions (60.7% male; median age 4.1 years). Infectious diseases were the most common reason for admission (78.7%), particularly deep neck and skin/soft tissue infections, all treated at home with intravenous antibiotics (54.2% using continuous infusion systems). Other reasons included sickle cell disease crises (6.2%) and initial diabetes management (6.2%). The median length of stay was 2.5 days. Eleven patients required readmission to hospital. Caregiver feedback was highly positive: 87% found the workload to be the same or lower than expected; 81% reported less disruption to daily routines (p < 0.05); and 95% noted improvements in at least one domain of child well-being. While 77% anticipated an excellent experience, 92% reported it exceeded expectations (p < 0.05). Most (86.4%) preferred home care, and 97% would opt for PHH again. Discussion: PHH proved to be a safe, effective model with high caregiver satisfaction. These results support the potential for the broader adoption of PHH, enhancing pediatric care and family-centered outcomes.

Keywords: Home hospitalization. Pediatric. Therapeutic. Satisfaction. Caregivers.