This work aimed to assess the safety and efficacy of transarterial embolization (TAE) for hemodynamically unstable blunt abdominal trauma in the pediatric population, and to explore optimal clinical treatment strategies for this population. This retrospective study included 18 consecutive pediatric patients (median age: 5years; interquartile range: 1.9-8years; 8 females, 10 males) who underwent TAE for hemodynamically unstable blunt abdominal trauma in the emergency department of Children's Hospital between May 2016 and September 2024. Angiographic results were evaluated, and the embolic materials used, complications, and clinical outcomes were recorded. Diagnostic angiography showed single-organ or single-site bleeding in 12 cases (66.7%) and two-site bleeding in six cases (33.3%). All bleeding sources were successfully embolized. Twelve patients (66.7%) were embolized with coil. After TAE, one case (5.6%) was combined with right thoracic closed drainage. Postoperative complications occurred in three (16.7%) children, including biliary fistula in two children and allantoic formation in one child. One child died of cerebral herniation and multiple-organ failure 10days after embolization. TAE demonstrates an acceptable mortality rate and low complication rate in the management of acute bleeding in hemodynamically unstable pediatric with blunt abdominal trauma. It is a viable therapeutic alternative for this patient population.

The global rise in the aging population presents significant challenges to healthcare systems worldwide, which thus need more efficiency and effectiveness. Healthcare systems deliver services through processes that encode (inter)national regulations and protocols for patient treatment. It follows that efficiency and effectiveness require improvement of healthcare processes. This paper introduces a novel methodology leveraging process mining and simulation to improve healthcare organizational processes through data-driven resource allocation. Traditional qualitative analyses and queuing theory offer limited scope for complex, multi-activity processes. In contrast, process simulation enables process improvement but requires a realistic simulation model; otherwise, the analysis may optimize an assumed process rather than the real one. This paper reports on a data-driven simulation methodology that builds on process mining techniques: process mining puts aside the subjectivity of process actors and focuses on the objectivity of transactional data recorded by information systems. This enables us to discover process simulation models that mimic real behavior. Simulation models support process improvement through the evaluation of alternative what-if scenarios, which can be tested without disrupting live operations. The methodology has been applied to the emergency department of an Italian hospital, focusing on reducing patient waiting times. Simulations involving a careful addition of medical staff demonstrated a potential substantial reduction in waiting times (88%) with a modest cost increase (7%-8%). Furthermore, the improved process exhibited enhanced resilience to surges in patient arrivals, highlighting how improved processes guarantee higher preparedness in front of emergencies.

The objective of this study was to utilize real-world data from National Poison Data System (NPDS) to evaluate the relative risk of intentional use and subsequent outcomes following exposures to buprenorphine buccal film (BBF) compared to immediate-release (IR) and extended-release (ER) full agonist opioid (FAO) formulations, and buprenorphine transdermal patch (BTP). A cross-sectional study design compared exposures that involved BBF to those that involved IR FAO, ER FAO, and BTP using real-world data from NPDS. Data included individuals age 18years and older involved in exposures managed by US poison centers from 2020 to 2023. Descriptive statistics were used to summarize study groups, exposures, and outcomes. Relative risk was calculated for exposure reasons and clinical outcomes using BBF as reference group. Dataset included 276 BBF, 43,322 IR FAO, 2453 ER FAO, and 134 BTP exposures. Compared to BBF, significantly higher risks were found for both IR FAO and ER FAO for intentional abuse, intentional suspected suicide, significant medical outcome, hospital admission, and treated/evaluated and released level of care. Findings from this study suggest that, compared to FAO, exposures to BBF managed by US poison centers were less likely to involve intentional abuse or suspected suicide, have a decreased risk of resulting in a life-threatening effect or death, and have a lower likelihood of subsequent hospital admission and emergency department visits. Along with published guidelines and medication labels (including boxed warnings), relative risks of intentional exposures and associated clinical outcomes should be considered when determining opioid therapy for pain management.

Evaluation of a street medicine based post-discharge care program for patients experiencing homelessness.

Use of standardized order sets and associated outcomes in the Emergency Department: A scoping review.

We examined whether the 116 emergency department transfers from residential aged care homes prevented by an intervention that provided on-site assessment and management following a fall led to a detectable shift in system-level emergency department utilisation. This 17-month before-and-after study was conducted at three metropolitan hospital emergency departments of a single health service in Melbourne, Australia. Monthly post-fall emergency department transfers from 108 residential aged care homes were compared before (1 May 2021 to 30 April 2022) and after (1 May 2022 to 30 September 2022) the intervention using two routinely collected administrative datasets. The primary analysis included patients eligible for the intervention. Sensitivity analyses examined patients ineligible for the intervention and a season-matched before period (1 May 2021 to 30 September 2021). Mean (SD) monthly post-fall emergency department transfers from residential aged care homes among patients eligible for the intervention were 92.2 (14.9) before and 74.2 (7.2) after implementation (mean difference [95% CI]: 18.0 [2.9, 33.1], p = 0.023; season-matched: 28.2 [10.3, 46.1], p = 0.007). Monthly post-fall emergency department transfers from residential aged care homes among patients ineligible for the intervention did not significantly differ before and after the intervention (mean difference [95% CI]: 1.8 [-3.0, 6.7], p = 0.434; season-matched: 1.8 [-5.1, 8.7], p = 0.566). We detected 78% (n ≈ 90) of the verified 116 emergency department transfers prevented. On-site assessment and management following a fall at residential aged care homes may reduce system-level emergency department utilisation. Examining sustainability and cost-effectiveness appears warranted.

Caring at the crossroads: Exploring end-of-life challenges for advanced heart failure patients in saudi emergency departments.

Door-to-electrocardiogram (D2E) time is a critical quality metric in evaluating patients with suspected acute coronary syndromes (ACS), yet adherence to the ≤10-minute benchmark remains suboptimal. This study aimed to quantify D2E performance, identify predictors of delayed EKG acquisition, and evaluate associations between D2E delays, in-hospital mortality, and length of stay (LOS). To quantify D2E performance, identify patient- and system-level predictors of delayed EKG acquisition, and evaluate associations between D2E delays, in-hospital mortality, and length of stay (LOS).​. This retrospective cohort study included adults presenting to a single community hospital emergency department in 2024 with symptoms suggestive of ACS. The primary outcome was receipt of a 12-lead EKG within 10 minutes of arrival. Secondary outcomes included D2E distribution, in-hospital mortality, and hospital LOS. Multivariable logistic regression examined predictors of D2E >10 minutes. Among 3,435 patients (median age 62 years; 52.3% female), 49.7% achieved D2E ≤10 minutes (median 10.0 minutes). In ACS subgroup analysis, female sex, atypical presentation, lower triage acuity, and afternoon shift were independently associated with D2E >10 minutes. Delayed EKG acquisition correlated with longer LOS, including a higher proportion of stays >4 days and a higher median LOS (3.0 vs. 2.0 days, p<0.01). Overall, in-hospital mortality was 6.5%. Fewer than 5 in 10 patients met the 10-minute D2E target. Delays were more frequent among women, patients with atypical presentations, lower triage acuity, and those arriving during afternoon shifts. Delayed EKG acquisition was associated with prolonged hospitalization, underscoring D2E time as a modifiable process measure. ​.

Background Acute poisoning remains one of the leading causes of emergency department admissions, hospitalizations, and preventable mortality worldwide. To gain an in-depth understanding of the clinical characteristics of acute poisoning and provide a basis for formulating precise prevention and control strategies, this study aims to evaluate the clinical characteristics and trend changes of acute poisoning admitted to the emergency department of a hospital in Zunyi City from 2021 to 2024. Methods This study retrospectively collected basic data on acute poisoning cases admitted to the emergency department of a tertiary general hospital in Zunyi City from January 1, 2021, to December 31, 2024. A descriptive analysis was performed on multiple characteristics, including age, gender, regional distribution, spring, and clinical outcomes. Results A total of 3,146 acute poisoning cases were admitted, 2,789 valid cases were obtained, with an effective rate of 88.65%. The three most common poisoning types were drug poisoning (1,192 cases, 42.74%), pesticide poisoning (611 cases, 21.91%), and chemical poisoning (593 cases, 21.26%). Ages were mainly concentrated in the 10–20 and ≥ 60 years age groups, and there was a statistically significant differences in the age composition of different types of acute poisoning ( χ 2 = 365.831, p &amp;lt; 0.001). The number of female patients (1,604 cases) was higher than male patients (1,185 cases), and the gender difference was statistically significant ( χ 2 = 42.068, p &amp;lt; 0. 001). The incidence had obvious seasonal characteristics, with the highest number of cases in winter (830 cases, 29.76%), and the difference in seasonal distribution was statistically significant ( χ 2 = 473.396, p &amp;lt; 0. 001). There was no statistically significant difference in regional distribution ( χ 2 = 11.702, p = 0.470), but the number of cases in county areas was the highest (421 cases, 15.10%). Temporal trends showed that the number of drug poisoning cases increased significantly in 2022 while chemical poisoning cases decreased, and both pesticide and food poisoning cases peaked in 2023. In terms of clinical outcome, 91.43% (2,550 cases) of patients were cured or in stable condition at discharge, with pesticide poisoning having the highest mortality rate (2.6%), followed by drug poisoning (0.7%). Conclusion Among the acute poisoning cases collected in this study, drug poisoning was the main type and showed an upward trend. The high-risk groups were the aged 10–20 and ≥60 years groups, and females, with the highest incidence in winter and no significant difference in regional distribution. Therefore, we should strengthen public education activities, enhance prevention and control for key populations, promote rational drug use, strengthen problem-solving strategies for proper drug storage, and improve the drug management and supervision system.

Even though children are typically more susceptible to radiation-induced illnesses than adults, pediatric radiology is an essential part of contemporary practice. Consequently, one of the most important performance metrics for patient safety is the appropriateness of radiologic procedures. The appropriateness criteria of the American College of Radiology (ACR) are evidence-based guidelines designed to assist referring physicians and other healthcare providers in decision-making regarding diagnostic imaging. Using ACR criteria as a reference, this study attempts to assess the suitability of radiologic procedures sought by pediatric emergency physicians. Furthermore, the investigation ought to pinpoint and emphasize possible causes of improper requests. A trainee operator consecutively collected 462 requests for radio diagnostic imaging for neurological diseases of the emergency department of an Italian pediatric hospital and used the pediatric panel of ACR criteria to rate the appropriateness of each request. Due to the absence of crucial clinical information, 24.7% of the requests were not complete. Of the complete requests, only 16.1% were classified as "usually appropriate", 29.9% as "may be appropriate", and 54.0% as "usually not appropriate". CT requests were commonly inappropriate (55.7%, p < 0.01). Overuse of CT scans can result in costly procedures and unwarranted radiation exposure. In pediatric practice, communication between radiologists and emergency physicians should encourage the use of evidence-based decision-making.

ObjectiveThis study explores prevalence and risk factors of problematic internet behaviours (PIBs) among youth who attended an emergency department (ED) for mental health (MH) concerns.MethodThis is a retrospective cross-sectional study of 237 patients aged 12-25 years who attended ED. Using a modified emergency department media use screener (mEDMUS) questionnaire and ED data, this study examined the association of socio-demographic and clinical predictors with PIB by applying bivariate and multiple logistic regression analysis.ResultsED presentation was related to PIB in 21.1% of participants. Female participants, those from culturally and linguistically diverse backgrounds, and individuals without a history of trauma were more likely to present with PIB. Multiple logistic regression analyses revealed that four internet-related behaviours (expressing aggression online, sending harmful content to others, deleting one's social media account, or accessing unhealthy ways of weight loss) were predictive of visits to the ED for MH concerns associated with online behaviours.ConclusionsThe findings of this study will help clinical services and policy makers gain a better understanding of young people's PIB in relation to their psychiatric symptoms. Future intervention studies should aim to broaden data collection techniques with long-term follow-ups, to explore how these online risk factors influence their everyday lives.

Background: Contaminated blood cultures complicate medical decision-making, leading to unnecessary testing and treatment. Objective: To evaluate the impact of an initial specimen diversion tube protocol on blood culture contamination rates in a community hospital emergency department. Methods: Over 9 weeks, 27 blood culture specimens were obtained using a diversion tube at the time of intravenous insertion. Trained nursing superusers collected samples. Contamination rates were compared with those from the standard protocol. Results: The standard protocol group demonstrated a 2.92% overall contamination rate (mean = 3.17%) with nine pathogens identified. The diversion protocol group showed a 3.70% overall contamination rate (mean = 2.38%) with only one pathogen isolated. Conclusions: Although the standard protocol had a slightly lower overall contamination rate, the diversion protocol yielded fewer pathogens and a lower mean contamination rate, suggesting greater potential for sustainable contamination reduction. Implications for Nursing: Nurse-driven interventions, including the use of diversion devices and superuser training, may enhance diagnostic accuracy and reduce unnecessary antibiotic exposure. Nursing engagement is essential to improving blood culture practices and sustaining quality outcomes.

Interruptions during triage: Characteristics and nurses' perception.

Infectious keratitis (IK) is a major cause of corneal blindness world-wide, and prompt identification of IK and its etiologic subtype is essential for appropriate management. We developed deep learning (DL) models to detect IK and differentiate common subtypes from slit-lamp photographs. In this retrospective study, slit-lamp photographs were collected from patients presenting to the emergency department of Farabi Eye Hospital (2014-2021) with bacterial keratitis (BK), fungal keratitis (FK), Acanthamoeba keratitis (AK), or herpes simplex keratitis (HSK), along with healthy controls and corneal scars. A total of 13,953 images were included. Three DL classifiers were trained: Model 1 (IK vs. normal), Model 2 (healthy vs. corneal scar vs. IK [pooled subtypes]), and Model 3 (BK vs. FK vs. AK vs. HSK). Model 1 achieved 99.9% accuracy for IK vs. normal (ROC-AUC 0.999). In five-fold cross-validation, Model 2 achieved mean accuracy 0.975 (95% CI 0.955-0.996), macro-F1 0.970 (95% CI 0.945-0.995), and macro-average AU-ROC 0.998 (95% CI 0.995-1.000). For subtype classification (Model 3), overall accuracy was 81.6% with balanced recall 83.3%; class accuracies were 88% (BK), 71% (FK), 72% (AK), and 93% (HSK) with ROC-AUCs 0.90-0.98. External validation of Model 3 (Ankara City Hospital; 665 images from 96 patients) showed accuracy 92.5%, macro-F1 93%, macro-average AUROC 0.996, and sensitivities of 95.2% (AK), 92.0% (BK), 85.5% (FK), and 99.5% (HSK). DL models applied to slit-lamp photographs showed high performance for IK detection and clinically relevant differentiation of IK from corneal scars and among major IK subtypes, with external validation supporting generalisability.

Digital emergency care applications offer potential to reduce delays, enhance triage, and improve care coordination, yet evidence remains limited on their real-world implementation at scale. Maccabi Healthcare Services developed Maccabi-RED, a mobile application allowing patients to request urgent community-based care as an alternative to hospital emergency department visits. This study examines the implementation and utilization of Maccabi-RED during 2020-2023, aiming to describe demographic and clinical characteristics of patients initiating emergency care requests, identify factors associated with request approval and successful routing to community-based care and examine healthcare utilization patterns following app-initiated requests. This retrospective study analyzed de-identified electronic health record data from Maccabi Healthcare Services, including all patient-initiated emergency care requests through the Maccabi-RED application between January 2020 and December 2023. The study included 94,795 requests from 77,508 patients. We extracted demographic and clinical variables and examine patterns of subsequent healthcare utilization in the week following app-initiated emergency care requests, comparing approved versus non-approved requests. During the study period, 51.6% of requests were approved, resulting in urgent community clinic appointments. Service utilization increased substantially from 11,058 requests in 2020 to 36,532 in 2023. Approved requests were more common among older patients and those with chronic conditions. Emergency type strongly influenced approval rates, with foreign body cases showing substantially higher approval odds than orthopedic cases. Geographic, ethnic, and socioeconomic disparities in approval rates were observed. In adjusted analyses, approved requests were associated with lower 7-day healthcare utilization, including fewer primary care physician visits and reduced odds of hospital emergency department and emergency medical center visits. The Maccabi-RED application demonstrates feasibility of scaling patient-initiated digital emergency routing, with potential to reduce downstream acute care utilization. However, observed approval disparities across age groups, geographic regions, and socioeconomic strata indicate that digital maturity alone does not guarantee equitable access. These findings underscore the importance of embedding equity considerations in system design, monitoring protocols, and capacity planning. Future development, including artificial intelligence-enabled decision support, should prioritize transparency and algorithmic fairness to improve performance without amplifying existing health inequities.

Carotid artery Doppler ultrasound, as a non-invasive monitoring method, offers higher clinical utility during cardiopulmonary resuscitation (CPR) compared to invasive techniques. This study aimed to investigate the application of real-time carotid Doppler ultrasound in CPR patients and analyze the predictive efficacy of waveform-derived parameters for return of spontaneous circulation (ROSC). This prospective observational study consecutively enrolled adult patients who underwent CPR in the emergency department of a tertiary hospital in Zhejiang Province between March 2024 and March 2025. ROSC was defined as the first documented confirmation at a scheduled pulse/rhythm check, independent of Doppler findings. Patients were divided into ROSC and non-ROSC groups based on whether ROSC was obtained. Baseline characteristics and carotid Doppler parameters were analyzed to evaluate their prognostic value. Univariate analysis compared baseline characteristics, CPR data, and carotid Doppler parameters between groups. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of statistically significant indicators for ROSC. Among 51 patients (23 in the ROSC group, 28 in the non-ROSC group). Significant differences were observed in carotid blood flow parameters between groups, including VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX (all P < 0.05). ROC analysis showed AUC values of 0.811 (VTI), 0.758 (Vmax), 0.727 (Vmin), 0.751 (cMD*) and 0.72 (dv.MAX), with optimal cutoffs of 18.8 87.1,19, 2318 and 8.75, respectively. Because ROSC was adjudicated at scheduled pulse/rhythm checks, the prespecified 60-second Doppler window before documented ROSC may have partially overlapped with spontaneous rather than purely compression-generated flow. Carotid Doppler parameters (VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX) significantly differ between ROSC and non-ROSC groups. These parameters may provide objective hemodynamic insights during CPR. However, these findings should be interpreted cautiously because the Doppler window preceding documented ROSC may have partially included ROSC-transition flow; therefore, the results are exploratory and require prospective multicenter validation.

Methanol poisoning remains a major public health problem, particularly during outbreaks related to illicit alcohol consumption, and is associated with high mortality. Early identification of patients at high risk of death is critical to guide timely triage and aggressive management in the emergency department (ED). To identify clinical and laboratory predictors of in-hospital mortality among patients with methanol poisoning during an outbreak and to evaluate the prognostic performance of key parameters using receiver operating characteristic (ROC) curve analysis and logistic regression. This retrospective observational cohort study was conducted in the ED of a tertiary-care hospital in Istanbul, Türkiye, during a methanol poisoning outbreak between December 1, 2024, and January 31, 2025. Adult patients (≥ 18 years) diagnosed with methanol poisoning were included. Demographic data, clinical findings, laboratory results, arterial blood gas parameters, and treatments were collected. The primary outcome was in-hospital mortality. ROC curve analyses and univariate and multivariable logistic regression models were performed. A total of 55 patients were included (92.7% male; median age 46.0 years [IQR 38.5-55.0]). In-hospital mortality occurred in 25 patients (45.5%). Non-survivors had significantly lower arterial pH, bicarbonate, and base excess values and higher lactate levels and anion gap compared with survivors (all p < 0.001). Arterial pH demonstrated excellent prognostic performance (AUC 0.969), with an optimal cut-off value of ≤ 6.89 (92.0% sensitivity, 96.7% specificity). In multivariable analysis, arterial pH remained an independent predictor of mortality, with each 0.1-unit decrease associated with a 2.78-fold increase in the odds of death. In a model excluding arterial blood gas parameters, higher lactate levels and lower Glasgow Coma Scale scores were independently associated with mortality. During methanol poisoning outbreaks, arterial pH is the strongest predictor of in-hospital mortality. Serum lactate and neurological status provide additional prognostic value when arterial blood gas analysis is unavailable. These findings support the use of arterial pH as a decision-support tool for early escalation of care, including emergent hemodialysis and intensive care admission, and suggest that serum lactate and GCS may serve as actionable triage parameters in resource-limited or high-burden surge settings.

Emergency department (ED) crowding is a persistent global issue, particularly in tertiary and university hospitals, where delayed admissions impair patient flow. This study aimed to evaluate the impact of implementing a transition ward (TW), established in May 2022 as a temporary inpatient care area to accommodate eligible admitted ED patients awaiting hospital beds, on ED crowding, focusing on reductions in boarding patient numbers and overall patient volume in ED. This prospective, observational, single-center study was conducted at the Adult ED of a tertiary hospital between April 23 and June 2, 2023. ED crowding data were collected six times per day, yielding a total of 216 data points. As a baseline reference, data from the identical period in 2021, before the implementation of the TW, were used for comparison. The primary outcomes were the number of boarding patients and the total number of ED patients. Secondary outcomes included the longest waiting time for admitted patients, and the longest waiting time for examination. Following the implementation of TW, the median total number of ED patients decreased by 22.0% (from 41.0 to 32.0; median difference -9.0, 95% CI: -10.4 to -7.7), and the median number of boarding patients decreased by 25.0% (from 23.5 to 18.0; median difference -5.5, 95% CI: -6.7 to -4.3). The median longest examination waiting time decreased by 40.2% (from 66.0 minutes to 39.5 minutes; median difference -26.5, 95% CI: -36.9 to -16.1). The TW was associated with significant reductions in total ED patient volume and boarding patient volume, particularly in a high-volume tertiary care setting. These findings suggest that TWs can contribute to measurable improvements in ED patient flow and reductions in access block. Based on these positive outcomes, similar units may be extended to other inpatient specialties.

BACKGROUNDHand injuries, particularly tendon injuries, are a common reason for emergency department visits and may significantly impact daily functioning. Traditional diagnostic approaches may fail to detect partial tendon injuries, highlighting the need for alternative imaging techniques. Ultrasonography (USG) has emerged as a rapid, non-invasive, and effective diagnostic tool for tendon injuries, particularly in emergency settings where magnetic resonance imaging (MRI) may not be readily available. This study evaluates the diagnostic effectiveness of ultrasonography in assessing tendon injuries among patients presenting with hand trauma in the emergency department (ED). Ultrasonography findings were compared with clinical evaluations to determine its role in diagnosing tendon injuries and guiding surgical management. This prospective observational study was conducted in the ED of a single tertiary-care hospital over a one-year period and included adult patients presenting with hand injuries.METHODSPatients who met the inclusion criteria underwent both clinical evaluation and ultrasonographic examination. A total of 68 patients were included in the study. All assessments were performed by an experienced emergency medicine physician using a Philips Affinity S70 ultrasonography system (Philips Healthcare, Bothell, WA, USA). Collected data included patient demographics, injury characteristics, ultrasonographic findings, and the need for surgical intervention. Statistical analyses were performed using the chi-square test and binary logistic regression to compare the diagnostic performance of the two methods.RESULTSUltrasonography demonstrated a sensitivity of 82.6% (95% confidence interval [CI]: 0.69–0.91), specificity of 90.9% (95% CI: 0.70–0.98), and an overall accuracy of 85.3% (95% CI: 0.75–0.92) in predicting the need for tendon repair. Clinical evaluation showed slightly lower diagnostic performance, with a sensitivity of 80.4% (95% CI: 0.67–0.89) and an accuracy of 80.9% (95% CI: 0.70–0.89).CONCLUSIONRegression analysis indicated that ultrasonography increased the likelihood of accurately diagnosing tendon injuries by 21.8 times compared to clinical assessment. Together, clinical evaluation and ultrasonography predicted 61% of all cases requiring tendon repair.

Inpatient care is costly, and an aging population, hospital bed shortages, and practitioner shortages stretch inpatient capacity. Alternative modalities of acute care delivery may support growing demands. To compare outcomes of hospital at home (HaH) vs traditional inpatient hospital admissions and to assess facility-level variability in HaH utilization. This propensity score-matched, retrospective, comparative effectiveness research study used data for age-qualifying (≥65 years) fee-for-service Medicare beneficiaries admitted from January 1, 2021, through December 1, 2022, within HaH-waivered US hospitals that had 12 or more HaH admissions. Analyses were completed from November 2024 to March 2026. HaH vs traditional inpatient hospitalization. Primary clinical outcomes were in-hospital mortality and hospital readmissions and emergency department (ED) visits within 30 days of index admission discharge. Facility-level characteristics were assessed for facilities that had HaH admissions above and below the median (≥149 admissions). Conditional logistic regression was used for dichotomous outcomes, with adjusted odds ratios (aORs) and 95% CIs reported. Log-transformed linear regression was used for skewed continuous outcomes within matched pairs, with adjusted percentage changes and 95% CIs reported. Among 15 871 Medicare beneficiaries (4174 HaH and 11 697 traditional inpatient admissions), the overall mean (SD) age was 77.4 (8.0) years, and 8396 beneficiaries (56.2%) were female. Of 313 HaH-waivered hospitals, 68 were eligible for inclusion, and 11 hospitals accounted for approximately 50% of all HaH admissions. Compared with traditional inpatient admissions, HaH admissions were associated with lower in-hospital mortality (16 of 4174 admissions [0.4%] vs 423 of 11 697 admissions [3.6%]; aOR, 0.09; 95% CI, 0.06-0.16) and lower ED use within 30 days of discharge (366 of 4174 admissions [8.8%] vs 1164 of 11 697 admissions [10.0%]; aOR, 0.86; 95% CI, 0.76-0.97), with no significant difference in readmissions within 30 days of discharge (490 of 4174 admissions [11.7%] vs 1282 of 11 697 admissions [11.0%]; aOR, 1.07; 95% CI, 0.96-1.20). In this retrospective comparative effectiveness research study of Medicare beneficiaries, HaH was associated with lower in-hospital mortality and ED use within 30 days of discharge, but not hospital readmissions within 30 days, compared with traditional inpatient care. These findings support HaH as an approach that may maintain similar or better short-term outcomes among appropriately selected patients; future studies should evaluate implementation and equity.