A Cochrane review (abstract , review [Abstract]) included 8 studies with a total of 870 patients. There was a significant reduction in readmission rates for hospital at home compared with hospital inpatient care of acute exacerbations of COPD (RR 0.76, 95% CI 0.59 to 0.99). Moreover, a trend towards lower mortality in the hospital at home group was observed, but the pooled effect estimate did not reach statistical significance (RR 0.65, 95% CI 0.40 to 1.04). For health-related quality of life, lung function (FEV1) and direct costs, the quality of the available evidence was in general too weak to make firm conclusions.
Comment: The quality of evidence is downgraded by imprecise results (wide confidence intervals).
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