A "home hospital" care model—where patients receive hospital-level care in their homes—shows cost-cutting promise and doesn't hurt quality or patient safety, according to a new study.
Though patients would prefer to receive care at home if possible, few "hospital at home" programs have cropped up across the U.S. Experts have suggested the model could ease issues with bed capacity and improve patient satisfaction.
Communication gaps between hospitals and home-based care providers persist, however, posing a significant patient safety challenge. Home health workers are often provided incomplete or inaccurate information, and they often lack access to electronic health records to doublecheck patient information.
Researchers at Boston's Brigham and Women's Hospital (BWH) conducted a randomized control trial on its pilot home hospital program and, in the small initial sample, found that the model cut healthcare costs in half.
Twenty patients who live near the hospital participated in the study, with nine receiving care at home and 11 in the hospital. The at-home model included a daily visit from a physician and two daily visits from a home health nurse. Patients could also connect to doctors outside of those visits through video chats or texting.
The researchers conducted interviews at admission, at discharge and within 30 days of care with the patients, who had one of several conditions including infections, chronic obstructive pulmonary disorder, heart failure and asthma. In addition to reduced costs, patients who were treated at home used fewer care resources and improved their physical activity, with no significant impacts on quality or safety, according to the study.
"We haven't dramatically changed the way we've taken care of acutely ill patients in this country for almost a century," David Levine, M.D., a primary care doctor at BWH and the study's lead author, said in an announcement.
"There are a lot of unintended consequences of hospitalization. Being able to shift the site of care is a powerful way to change how we care for acutely ill patients and it hasn’t been studied in the U.S. with intense rigor," Levine added.
The initial pilot trial was a small patient sample, but Levine and his team have already sized up the study to include a larger number of patients.