Hospital at Home - Update
SUMMARY:
November 2020: CMS announces Hospital at Home Program
Countries around the globe have focused on hospital at home services.
Available data indicates non-inferiority of Hospital at Home outcomes.
Significant benefits in mortality and admission to hospital are lacking.
REVIEW
The health care landscape has been migrating from inpatient to outpatient over the past 4 decades.
Hospital at Home services have been evaluated and documented since 1999.
Hospital at Home has been advocated for providing certain advantages:
Avoiding hospital admission
Support early discharge from the hospital
Decrease risk of in hospital adverse events
The aging population along with the rise of remote patient monitoring devices have also help drive the adoption of Hospital at Home services.
Recently the Cochran Database of Systemic Reviews has evaluated and published the data on Hospital at Home published manuscripts.
17 studies from 1999 to 2021 were identified.
References
Diagnoses recruited for Hospital @ Home programs were:
COPD
Stable moderate to severe stroke
Any infection
Heart failure
Asthma exacerbation
Community Acquired Pneumonia
Neuromuscular diseases”
Undefined “Acute Medical Condition
Outcomes evaluated included:
Mortality
Hospital admission after Hospital @ Home
Living in Residential care after Hospital @ Home
Quality of life
Functional activity
Psychological health
Provider satisfaction
Length of stay
Cost & Resource use
Not all studies evaluated each outcome
CONCLUSIONS:
Hospital at Home is a viable alternative to inpatient care for select patients.
While reducing costs, Hospital at Home makes little difference in mortality and patient outcomes while improving satisfaction and reducing the likelihood of transfers to residential care.