Evaluating Racial/Ethnic Differences in Care Escalation Among COVID-19 Patients in a Home-Based Hospital

Liu, Tsai‐Ling; Chou, Shih-Hsiung; Murphy, Stephanie; Kowalkowski, Marc; Taylor, Yhenneko J.; Hole, Colleen; Sitammagari, Kranthi; Priem, Jennifer S; McWilliams, Andrew

doi:10.1007/s40615-022-01270-1

Cited by 8 publications

(3 citation statements)

References 31 publications

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“…This was not a randomized controlled study, but an observational one. In addition, in order to create the comparison population, we were unable to establish whether all of the comparison patients would have been eligible for medical care in the Kaiser Permanente model, thus making it di cult to ensure clinical comparability.Although questions have been raised regarding whether ACaH can provide equitable care or deliver care to socioeconomically disadvantaged patients, our results are consistent with prior work which demonstrates that low SES patients had better or equivalent outcomes than high SES patients (6) and that care escalation rates didn't vary by race or ethnicity(7). This work underscores the need for ongoing research in health care equity in ACaH care delivery.…”

supporting

confidence: 88%

Equity in the Advanced Care at Home Model In an Integrative Healthcare System

Mashaw,

Snyder

2023

Preprint

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Advanced Care at Home (ACAH) provides hospital-level care as a substitute for traditional facility-based hospital care. However, there are still concerns regarding equity of care to different socioeconomic groups for this model of care. This retrospective cohort study compared socioeconomic indicators between typical hospital care and an ACAH model in an integrated healthcare system. By utilizing demographics, Neighborhood Deprivation Index (NDI), Medical Financial Aid (MFA) status, and insurance status as proxies for socioeconomic status, our data suggests that care was provided at similar rates to traditional hospital care regardless of age, race, ethnicity, insurance status or degree of social deprivation. In patients in the 4th of 5 NDI quintiles (higher socioeconomic needs), a higher percentage were treated in the ACAH model (20.4% vs. 14.2%; P < 0.00001). 16.9% of Kaiser Permanente at Home patients had applied for MFA within 6 months of admission compared with 13.5% of hospital patients (P = 0.00001).

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supporting

confidence: 88%

Equity in the Advanced Care at Home Model In an Integrative Healthcare System

Mashaw,

Snyder

2023

Preprint

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“… 1 , 2 , 3 Protocols for and preliminary outcomes of COVID-19 patients discharged from the ED with supplemental oxygen have recently been reported. 1 , 4 , 5 , 6 A study of 194 patients with mild exertional hypoxia discharged from New York EDs with oxygen concentrators early in the pandemic found relatively low 30-day ED returns and mortality rates. 4 Outcomes of patients treated at home with supplemental oxygen have been reported; however, these studies appear to include primarily patients discharged from inpatient hospitalizations or for whom supplemental oxygen was implemented by a physician at home.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Outcomes of 360 Consecutive COVID-19 Patients Discharged From the Emergency Department With Supplemental Oxygen

Terp

Reichert

Burner

et al. 2023

Annals of Emergency Medicine

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“…To date we have identified 7 HaH studies utilizing digital sensors, platforms, and mostly virtual care evaluating the clinical outcomes of acute care HaH programs 56,[59][60][61][62][63][64] . Three of these studies demonstrated the ability to provide COVID-19 acute hospital care in the home and increase surge capacity without adverse outcomes.…”

Section: Evidencementioning

confidence: 99%

The hospital at home in the USA: current status and future prospects

Pandit,

Pawelek,

Leff

et al. 2024

npj Digit. Med.

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The annual cost of hospital care services in the US has risen to over $1 trillion despite relatively worse health outcomes compared to similar nations. These trends accentuate a growing need for innovative care delivery models that reduce costs and improve outcomes. HaH—a program that provides patients acute-level hospital care at home—has made significant progress over the past two decades. Technological advancements in remote patient monitoring, wearable sensors, health information technology infrastructure, and multimodal health data processing have contributed to its rise across hospitals. More recently, the COVID-19 pandemic brought HaH into the mainstream, especially in the US, with reimbursement waivers that made the model financially acceptable for hospitals and payors. However, HaH continues to face serious challenges to gain widespread adoption. In this review, we evaluate the peer-reviewed evidence and discuss the promises, challenges, and what it would take to tap into the future potential of HaH.

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Evaluating Racial/Ethnic Differences in Care Escalation Among COVID-19 Patients in a Home-Based Hospital

Cited by 8 publications

References 31 publications

Equity in the Advanced Care at Home Model In an Integrative Healthcare System

Equity in the Advanced Care at Home Model In an Integrative Healthcare System

Characteristics and Outcomes of 360 Consecutive COVID-19 Patients Discharged From the Emergency Department With Supplemental Oxygen

The hospital at home in the USA: current status and future prospects

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