Objectives To compare the outcomes of readmission, mortality and treatment‐related complications in older people treated by hospital in the home (HITH) for acute decompensated congestive cardiac failure (CCF) with those treated in hospital. Methods Retrospective cohort study of patients 65 years and older treated by HITH over a 30‐month period compared with age‐ and sex‐matched patients treated in hospital. Results There was no difference between the “HITH” and “Hospital” cohorts in mortality within 60 days of discharge (P = 0.5), time to death (P = 0.8), 30‐day (P = 0.7) and 60‐day (P = 0.4) readmissions, time to readmission (P = 0.9) and complication rate (P = 0.1). HITH patients had longer length of stay (P = 0.001) but lower cost per day of admission ($669.42 vs $1377.58). Conclusion In appropriately selected older patients, HITH is a safe, efficacious and cost‐effective alternative to inpatient management of acute decompensated CCF.

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