Hospital at home: emergence of a high-value model of care delivery

Abstract

Background With increasing healthcare demands for acute illness in patients especially in the times of pandemic, healthcare organizations require modern solutions. Hospital at home (HaH) is one such tool that has the potential to solve these problems without compromising the care of the patients. Main body Hospitals have been the conventional setting for managing acute sickness patients; however, it could be a very challenging environment for a few patients, especially for the older population who are highly susceptible to hospital-acquired infections. Health care in a hospital setting can also be very expensive, as it often involves a lot of healthcare professionals providing care. HaH service can provide the same quality of care expected in traditional settings. Conclusions The median length of stay and the rate of readmissions were lower in people under HaH care. Compared with patients in a hospital setting, patients in HaH had better clinical outcomes. HaH unit provides an integrated, flexible, easy-to-scale platform that can be cost-effectively adapted to high-demand situations.

Integrating Step-down Care in Community-based Paediatric Palliative Services: A Realist Evaluation

“…The study provides insights into the challenges of long-term care for children with chronic illnesses with no prospects of recovery or cure. The COMET program emerges as a possible solution to this persistent concern, building on existing hospital-at-home models [11] and emphasizing tailored service provisions over location. As a unique iteration within community-based palliative care, COMET supports patients’ needs in situ , notwithstanding their current health state.…”

“…2. Embrace a care model focusing on adjusting care intensities rather than moving patients between different settings [11], fostering continuity in patient-provider relationships and enabling responsive caregiving with fewer administrative concerns. 3.…”

“…In response to care gaps and client feedback, Star PALS initiated a progressive step-down programme called COMET from November 2020. Modelled after strategies from Intensive Care Units [10,11], the programme targeted those: (i) without pressing specialist PPC requirements; (ii) with longer expected survival; (iii) demonstrating variable care needs; and (iv) lacking appropriate community follow-up options. COMET involved lower-intensity management within specialist PPC services for enrolled patients—reducing consultation (home visits) frequency and access to certain benefits, while preserving crucial crisis assistance, emergency visits, medication access, and remote support.…”

Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study

“…With hospital closures on the rise in rural parts of the United States and more than 70% of all adult hospital beds in the country occupied, programs like hospital-at-home (H@H) offer improved access to care for patients who might otherwise face treatment delays. 1 , 2 Since its first trials in the 1980s in the United States, the H@H model has demonstrated noninferior and, sometimes, improved outcomes for patients suffering an acute episode compared to brick-and-mortar care. 3 , 4 Yet, to receive H@H, patients must integrate monitoring, supply and medication delivery, and emergency visits at home in their daily routines.…”

“…Abbreviations: NWWI, Northwest Wisconsin region; CCS, clinical classification software; CHF, congestive heart failure; ACH, advanced care at home; MSK, musculoskeletal; COVID-19, coronavirus disease 2019 1. Chi-Square P-value 2. Fisher Exact P-value 3.…”