To assess the hypothesis that In Home Hospital Care (IHHC) is as safe and effective, less burdensome to families, and less expensive for care of common acute pediatric problems now managed with hospitalization.

A randomized trial compared health care systems with and without IHHC. Eligible children presented to the Emergency Department of our medical center, had common acute problems, and were considered for hospital admission.

Physicians decided disposition from the emergency department. Note that subjects were not randomized directly to IHHC but to a system of care that either included IHHC or did not. To allow best use of scarce home nursing resources, we used a disproportionate selection favoring the system with IHHC.

Quality measures included adverse events, parent anxiety and satisfaction with care, family disruption, and perceived child health.

Inclusion Criteria:

Randomized from acute care clients presenting in Emergency Department to IHHC

Exclusion Criteria:

Randomized from acute care clients presenting in Emergency Department to inpatient hospital care.