The Hospital at Home program is an innovative care model that provides safe, high-quality, hospital-level care to older adults in the comfort of their own homes. Developed by the Johns Hopkins Schools of Medicine and Public Health, this program has been tested at medical centers across the country and has several key benefits: 

• Cost Reduction: Hospital at Home lowers costs by nearly one-third compared to traditional hospital care. 
• Complication Reduction: It also reduces complications associated with hospital stays. 
• Patient Satisfaction: Patients and caregivers alike highly rate this care model. 

Here’s how it works: 

If eligible, a patient consents to participate. 

The Hospital at Home® physician evaluates the patient and arranges transportation home (usually by ambulance). 

Once home, the patient receives extended nursing care initially, followed by at least daily nursing visits based on clinical need.

This exciting idea of receiving hospital-level care at home has gained momentum, challenging traditional healthcare delivery. A recent study suggests individuals receiving hospital-level care at home tend to fare just as well as those in a hospital setting, if not better.  We know that patients get better faster at home with their family and pets. After all, what we offer in a hospital setting is below par food, an uncomfortable bed and chairs, and constant interruptions to sleep.  

Advancements in technology allow hospitals to offer a wide spectrum of services at home. Patients can undergo X-rays, intricate heart scans, receive IV medications, have lab tests, and have meals and medications delivered to the bedside.  Vital signs can be monitored remotely, and daily in-home nurse visits are coupled with daily telehealth from a medical provider and access to 24 hour on-call nurses and physicians. 

A recent study published in the Annals of Internal Medicine on January 9, 2024, reported patients receiving hospital-level care at home experience low mortality rates and are less likely to encounter emergencies needing immediate hospital returns. David Michael Levine, MD, Clinical Director for Mass General Brigham’s Healthcare at Home Program, analyzed 5,900 patients under the Medicare waiver program. The complex medical conditions among these patients included heart failure, COPD, cancer, and dementia. Despite the severity of their conditions, only 0.5% expired and approximately 6% were admitted back to the hospital for further care. Upon completion of the home care treatment, the patients continued to do well. After leaving the home care program, the study found that within 30 days approximately 3% were admitted to a nursing facility, 16% were admitted to a hospital for treatment, and 3% expired. 

Other healthcare organizations have reported different statistics, but outcomes for patients who received home hospitalization report favorable results. Dr Levine said “since we show patients how to take care of themselves right in their homes, where they are also more likely to be upright and move more” patients transition easier when their hospitalization ends.  Home hospitalization allows the healthcare provider to experience how patients are living day-to-day and make recommendations based on the surroundings making a negative impact on the patient’s life. “For example, we can discuss a patient’s diet right in the kitchen or link a patient with resources when we see the cupboards are bare.” Dr Levine stated. 

Different from home care prescribed by physicians and administered by agencies, this care is directed by a team responsive to the patients’ needs. Pain medication is an area often presenting problems during agency home care. This area can be more skillfully managed with Hospital at Home care. Older patients have longed for the return of “house calls” and the traditional care from a physician who knew who you were. This can be a return to that type of personal care while surrounded in a familiar environment. 

As hospital-level care at home continues to demonstrate its success, cost-effectiveness, and patient-centric approach, it brings a shift in healthcare delivery. The combination of technological advancements, comprehensive in-home services, and the focus on patients’ well-being marks a pivotal moment in reshaping healthcare models. Ideas of expanding these models across the nation offer a promising path to accessible, high-quality healthcare.  As Hospital at Home programs evolve, emphasis must remain on empowering patients and redefining the boundaries of care beyond hospital walls.