Hospital-Level Care at Home for Acutely Ill Adults: a Pilot Randomized Controlled Trial

Abstract

The use of substitutive home-hospitalization compared to in-hospital usual care reduced cost and utilization and improved physical activity. No significant differences in quality, safety, and patient experience were noted, with more definitive results awaiting a larger trial. Trial Registration NCT02864420.

Postacute Care Preparedness for COVID-19

“…The current average level of care, however, will be insufficient to manage higher acuity patients with COVID-19 transitioning from the hospital. One potential solution is increased investment in hospital-at-home models, 6 which provide institutional-level services in the home.…”

Medical Rehabilitation in Pandemics: Towards a New Perspective

“…Although rehabilitation in the patient's own home is an option, this will be limited by inability to manage high acuity patients with COVID-19. Therefore, care models where institutions provide 'hospital at home' services are more feasible (13). Delivery of ambulatory care services will need to use 'Telemedicine' rather than face-to-face care model, where possible.…”

Review of potential high-leverage and inexpensive mitigations for reducing risk in epidemics and pandemics

“…For abdominal and chest pain, some basic diagnostic tests could be done at home, and automated diagnostic criteria could be applied to suggest treatment if doctors are unavailable. It seems little of this is currently done routinely, even though in some cases of acute illness, home provision of care is already more helpful than hospital care 86 not to mention far less expensive. Even when home care is inferior, research into the extent to which home care is possible, and investigation and preparation of resources could be valuable not only as a contingency, but as a supplement to current health-care offerings.…”