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Hospital-level care at home…Is that a thing?

By: Julie Cullen

Last week I shared an article about the decreasing number of hospitals in the United States and wondered about what that would mean for healthcare. Where will care take place if not in the hospital? Then, this morning, I encountered a story on NPR about “hospital-at-home” care.

At Brigham and Women’s Faulkner Hospital in Boston, some patients can opt to have their “hospital stay” at home. They’re visited by providers and nurses twice a day in and wear a small monitor that tracks vital signs and movement.

In the scenario described in the story, a physician recommends this care option to a 71-year-old woman with pneumonia, explaining to her that by staying home, she can avoid some of the pitfalls of hospitalization, including infection and sleeplessness. That sounds great to me. I remember my last hospital stay a few years ago seemed to be one sleep interruption after another. And I friend of mine ended up with C. Diff while in the hospital.

A 2016 small, randomized, controlled trial compared the healthcare use, experience, and costs of Brigham patients who received either hospital-level care at home or in the hospital. The study, published in the Journal of General Internal Medicine, found that home-care patients experienced no adverse events and their treatment costs were significantly lower—about half that of patients treated in the hospital. The lower labor costs associated with home care accounted for most of that reduction, in addition to fewer lab tests and visits from specialists. Both groups of patients were happy with their care, but the patients at home were more physically active. In addition, caregivers reported less stress when they didn’t have to travel to the hospital to visit their loved ones.

Obviously, hospital-at-home care isn’t appropriate for all situations…or even all patients…but it seems like an option worth paying attention to. I should also point out that insurance companies aren’t sold on the idea yet, so I’m sure more studies will be forthcoming. I’ll keep my eye out for them and share when I can.

Source: npr.org/sections/health-shots/2018/03/07/591018896/patients-like-hospital-care-at-home-but-some-insurers-are-skeptic

Julie Cullen, managing editor of American Nurse Today and a curator of online content for the American Nurse Today website, is most definitely not a nurse, but she admires what all of you do everyday. In her Off the Charts blog she shares some of her experiences as a patient and family member of patients, thoughts and ideas that occur to her during her work editing nursing content, and information she thinks you might find interesting. Julie welcomes your feedback. You can submit a comment on the website or email her at jcullen@healthcommedia.com.


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