Please select the eligibility criteria that correspond to the clinical trial below.
Title: Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial
Brief Summary: The investigators propose a home hospital model of care that substitutes for treatment in an acute care hospital. Limited studies of the home hospital model have demonstrated that a sizeable proportion of acute care can be delivered in the home with equal quality and safety, reduced cost, and improved patient experience.


Options:
A: Inclusion Criteria:

Nursing homes

* German-speaking
* Size: ≥80 long-term care beds (NHs with \>60 beds will be considered if they have a high hospitalisation rate)
* Hospitalisation rates: ≥0.8/1000 resident days

Residents

- All long-term care residents

Geriatric nurse experts:

* Registered nurse
* At least three years' experience in long-term care

Nursing home staff

* Care workers of all educational levels, including students
* Other health professionals employed by the NH (such as therapists, dieticians) with direct resident contact
* Employed by the NH and working in the NH for a minimum of 3 months

Exclusion Criteria:

Nursing homes

* Italian-speaking
* French-speaking

Residents

- Short term or day care residents, other residents with a discharge planned within two months after admittance
B: Inclusion Criteria:

* Resides within either a 5-mile or 20 minute driving radius of emergency department
* Has capacity to consent to study OR can assent to study and has proxy who can consent
* \>= 18 years-old
* Can identify a potential caregiver who agrees to stay with patient for first 24 hours of admission. Caregiver must be competent to call care team if a problem is evident to her/him. After 24 hours, this caregiver should be available for as-needed spot checks on the patient. This criterion may be waived for highly competent patients at the patient and clinician's discretion.
* Primary or possible diagnosis of cellulitis, heart failure, complicated urinary tract infection, pneumonia, COPD/asthma, other infection, chronic kidney disease, malignant pain, diabetes and its complications, gout flare, hypertensive urgency, previously diagnosed atrial fibrillation with rapid ventricular response, anticoagulation needs, or a patient who desires only medical management that requires inpatient admission, as determined by the emergency room team.

Exclusion Criteria:

* Undomiciled
* No working heat (October-April), no working air conditioning if forecast \> 80°F (June-September), or no running water
* On methadone requiring daily pickup of medication
* In police custody
* Resides in facility that provides on-site medical care (e.g., skilled nursing facility)
* Domestic violence screen positive
* Acute delirium, as determined by the Confusion Assessment Method
* Cannot establish peripheral access in emergency department (or access requires ultrasound guidance)
* Secondary condition: end-stage renal disease, acute myocardial infarction, acute cerebral vascular accident, acute hemorrhage
* Primary diagnosis requires multiple or routine administrations of intravenous narcotics for pain control
* Cannot independently ambulate to bedside commode
* As deemed by on-call medical doctor, patient likely to require any of the following procedures: computed tomography, magnetic resonance imaging, endoscopic procedure, blood transfusion, cardiac stress test, or surgery
* High risk for clinical deterioration
* Home hospital census is full (maximum 5 patients at any time)
C: Inclusion Criteria:

* Adult patients, 18 years of age and older.
* Present to one of the participating hospitals.
* Have a chief complaint of one of the target diagnoses.
* Are within a certain geographical area (based on zip codes).
* Have a health insurance plan that covers ACH services.
* Have the capacity to consent or could assent with the consent of a health care proxy who is physically present.

Exclusion Criteria:

* The patient is not suitable for ACH or inpatient hospital care based on:

  * being a nursing home patient;
  * on or requiring dialysis;
  * positive for COVID-19;
  * having discharge order;
  * requiring intensive care unit (ICU) level of care;
  * history of drug abuse.
* Patients will also need to meet the clinical stability criteria.
* Do not have the capacity to consent or assent with the assistance of a health care proxy.
D: Inclusion Criteria:

* Confirmed stroke according to WHO´s criteria
* \> 18 years of age
* Living within 30 min from the stroke unit
* On day 2 NIHSS (National institute of health stroke scale) (22) of 0-16 points and Barthel 50-100 points.
* MoCA index \< 26 if Barthel = 100.

Exclusion Criteria:

* NIHSS \> 16
* Barthel \< 50
* Life expectancy \< 1 year (as with severe malignancy)
* Does not speak or communicate in Swedish prior to the incidence

Answer: B