Home Hospital Model Creates Capacity, Delivers Quality Care

THURSDAY, Aug. 26, 2021 (HealthDay News) — A small home hospital team can create substantial inpatient capacity while delivering high-quality acute care at home, according to a concise research report published online Aug. 6 in the Journal of General Internal Medicine.

David Michael Levine, M.D., M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues analyzed outcomes for Brigham’s home hospital program for treatment of 65 acutely ill patients without COVID-19 during pandemic surge conditions (March 15, 2020, to June 18, 2020), amounting to 419 bed-days. Home hospital care included daily in-home or remote visits from an attending general internist and two daily in-home visits from a registered nurse, plus 24-hour continuous monitoring, video, and texting through a mobile integrated health paramedic.

The researchers reported that infection (59 percent) and heart failure exacerbation (22 percent) were the most commonly cared-for conditions, with a length of stay of five days and an escalation rate of 3.1 percent. Nearly two-thirds of patients (65 percent) were discharged without services, while 12.3 percent were readmitted within 30 days and 13.8 percent presented to the emergency department within 30 days.

“Home hospital programs can create much-needed capacity by building on programs that many hospitals already have in place and do not require the financial and staffing resources of other approaches, such as field hospitals,” Levine said in a statement. “Home hospitals may represent a key response mechanism for a pandemic, but there’s also great evidence for their use when there isn’t a pandemic — patients have good outcomes, and they report great experiences receiving care at home.”

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