INTRODUCTION: Hospital-at-home programmes are well described in the literature but not in Asia. We describe a home-based inpatient substitutive care programme in Singapore, with clinical and patient-reported outcomes. METHODS: We conducted a retrospective cohort study of patients admitted to a hospital-at-home programme from September 2020 to September 2021. Suitable patients, who otherwise required hospitalisation, were admitted to the programme. They were from inpatient wards, emergency department and community nursing teams in the western part of Singapore, where a multidisciplinary team provided hospital-level care at home. Electronic health record data were extracted from all patients admitted to the programme. Patient satisfaction surveys were conducted post-discharge. RESULTS: A total of 108 patients enrolled. Mean age was 67.9 (standard deviation 16.7) years, and 46% were male. The main diagnoses were skin and soft tissue infections (35%), urinary tract infections (29%) and fluid overload (18%). Median length of stay was 4 (interquartile range 3-7) days. Seven patients were escalated back to the hospital, of whom 2 died after escalation. One patient died at home. There was 1 case of adverse drug reaction and 1 fall at home, and no cases of hospital-acquired infections. Patient satisfaction rates were high and 94% of contactable patients would choose to participate again. CONCLUSION Hospital-at-home programmes appear to be safe and feasible alternatives to inpatient care in Singapore. Further studies are warranted to compare clinical outcomes and cost to conventional inpatient care.
Aftercare ; Aged ; Female ; Hospitalization ; Humans ; Length of Stay ; Male ; Patient Discharge ; Retrospective Studies ; Singapore

INTRODUCTION. Refractive errors and visual impairment continues to be a worldwide problem. Asymptomatic children are showing visual impairment on routine visual screening. Early detection is important to prevent vision loss.

OBJECTIVES. To assess the prevalence and the type of refractive error and visual impairment among Filipino children at a private school.

DESIGN. A cross sectional study.

METHODS. A total of 352 children enrolled in the school year 2005-2006 at a private school with a mandatory visual screening program were included. Children were divided into symptomatic or asymptomatic. The examination include visual acuity measurement and non cycloplegic refractions.

MAIN OUTCOME MEASURE. Visual acuity and refraction was done by a board-certified Ophthalmologist assisted by the author and 4 staff nurses. Symptomatology were recorded and children were tallied as to Asymptomatic and Symptomatic. The types of error of refraction were recorded and tallied. Visual impairment was also recorded as to degree.

RESULTS. The prevalence of male with visual impairment is 33.23% and females showed 28.12% for a total of 66.74%. Of the 352 children only 11 or 3.12% had symptoms. Simple or one defect was found in 22.30% of the children and compound or 2 or more impairment were found in 37.8%. Astigmatism was found in 19.44%, Myopia alone in 14.81%, Hyperopia alone in only 3.24% and a combination of the above was 62.50% in these children. Of the 57 children prescribed with the corrective glasses only 19 or 33.33% complied.

CONCLUSION. The examined children showed no predilection as to gender. The primary grade level is more vulnerable to visual impairment. Astigmatism was found to be the major cause of visual impairment in this study. Visual impairment was found in majority of the asymptomatic children.

Refractive Error ; Visual Impairment