British Medical Journal (The BMJ)Why Spend Billions on Hospital Beds When You Can Care for Patients at Home?

With the shifting landscape of healthcare, Hospital at Home (HaH) programs are gaining momentum worldwide. These innovative care models are transforming the way we deliver acute medical care, enabling it to be safe, patient-centred, and more cost-effective.

Key Points:

• HaH programs allow patients to receive full assessments and treatments at home, improving patient safety and reducing the costs associated with hospital stays.
• More than 250 HaH programs are currently operating in the US, with other countries like Spain, France, Australia, the UK, Singapore, and Israel also leading in this initiative.
• A successful HaH program hinges on multidisciplinary teamwork, streamlined communication, integrated records, and effective use of new technologies.
• The definition of HaH should only encompass programs that provide hospital-level care at home, excluding chronic disease management and non-acute care.

Additional Points:

• The various models of HaH are known by different names across countries, such as Hospital in the Home, Intensive Home Care, Intensive Home Medicine, Admission Avoidance, and Virtual Wards.
• These programs encompass a wide range of care types, including post-operative recovery and rehabilitation, bone marrow transplant, complex chemotherapy regimens, IV antibiotics and antivirals, transfusions of blood products, and respiratory support.
• HaH services generally deliver as good or better outcomes than inpatient care, with comparable or shorter lengths of stay and readmission rates.
• Advanced technologies, including AI and machine learning, play a significant role in identifying suitable patients for HaH care and monitoring patients’ conditions.

Conclusion:

• Although HaH programs are a promising solution to many of the challenges of traditional hospital care, they necessitate new regulatory and payment frameworks, changes in entrenched hospital-oriented medical cultures, and significant buy-in from patients, carers, and the public.

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