A "hospital at home" model can improve outcomes while also making for a better patient experience, according to a new study.
Researchers at Mount Sinai Health System in New York followed about 500 patients from November 2014 to August 2017, with more than half receiving care in the home hospital model while the rest were given traditional inpatient care. Patients in the home care model were provided physicals, vital signs monitoring, intravenous medications and wound care by a physician or nurse practitioner outside of the hospital.
Patients in the hospital at home program had an 8.6% readmission rate compared to 15.6% for the control group, and a 3.2-day average length of stay compared to 5.5 days. The study also found that these patients were less likely to visit the emergency department and were significantly less likely to require a transfer to a skilled nursing facility for post-acute care.
Albert Siu, M.D., one of the study's authors and chair emeritus of the Brookdale Department of Geriatrics and Palliative Care in the Icahn School of Medicine at Mount Sinai, told FierceHealthcare that though the program can't offer every inpatient service at home, the results are proof that the model could be a safe alternative for many patients.
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"We found that we could do the hospital services at home," he said.
In addition, patients in the program had a more positive experience, according to the study. Nearly 68% rated their care highly, compared to just over 45% for those admitted to the hospital.
Siu said the patients in the home model were also more likely to say they had positive interactions with the clinicians providing care.
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Mount Sinai's findings come on the heels of a study released earlier this year by Brigham and Women's Hospital, which was also piloting a home hospital program. That study found that in a small pilot sample of 20 patients, nine of whom were treated at home, the program cut costs in half.
Mount Sinai also estimates that its program would lead to significant cost savings. The researchers project that about 575,000 people each year would qualify for the hospital at home model, and if even just a fifth of those patients were enrolled, it would save Medicare $45 million annually.
Siu said that Mount Sinai is looking to expand access to the program and has been working with the Centers for Medicare & Medicaid Services and private payers to do so.
"We have been very interested in trying to make this more available, not only to our community but around the country," he said.