Hospital-at-home: Lower costs, improved outcomes

Patients with certain conditions may have a new care option that allows them to bypass longer inpatient stays and receive higher levels of care at home. Hospital-at-home, or HaH, is growing in the U.S. as demand increases for inpatient beds and health systems look for ways to control costs, according to Healthcare Finance. While the concept has been studied and utilized to some degree since the 1970s, interest has increased dramatically over the past few years as more baby boomers age into Medicare and the cost of care continues to rise.

How it works: In order to be eligible for HaH care, patients must be medically stable with conditions that can be managed remotely and have stable housing with functioning HVAC and climate control, according to the American Hospital Association. HaH patients also need reliable social support with caregivers who can assist them during their at-home hospitalization. Patients receive daily visits from providers in their homes or through telehealth appointments. Care teams can remotely monitor patients around the clock using devices that collect data (such as blood pressure or oxygen saturation).

For patients, the benefits include a familiar environment with their preferred foods and uninterrupted sleep. According to Forbes, the routine nighttime wake-ups, beeping machines, and fluorescent lighting in hospitals can be disorienting. And according to the American Hospital Association, a more restful environment helps prevent the onset of delirium, reduces infection and fall risk, and promotes greater mobility. In addition, for caregivers who spend long hours looking after their loved ones, patient homes are usually more comfortable and spacious than a busy hospital room with a couch or chair at most.

The benefits are increasingly clear as more hospitals and health systems adopt HaH programs. According to a study published in 2021 in JAMA Network Open, patients in HaH programs had a similar mortality risk as patients in traditional inpatient settings, but their readmission risk decreased by 26 percent, along with a decreased risk for admission into a long-term care facility.

Another study published in the Journal of Clinical Oncology found that HaH reduced the odds of unplanned hospitalization by 55 percent and healthcare costs by 47 percent over one month.