Hospital at Home: An Overview of Literature

Abstract

The development of new management solutions is needed to generate great changes in the health sector, especially in addressing the current collision course between growing health care demands, rising costs, and limited resources. One of these solutions is the hospital at home (HAH). This article aims to explore the existing literature, regarding possible health gains and economical outcomes in HAH programs versus traditional inpatient hospitalization. A search of literature was conducted to identify papers regarding HAH programs and their respective health and economical outcomes. The concept of HAH encompasses different levels or care schemes. Several examinations and treatments can be carried out at home. Hospital at home may optimize patient flow and relieve pressure on hospital bed availability. However, questions are raised regarding the uncertainty of the efficacy of HAH and the limited evidence on which model setting is most appropriate.

Hospital at Home for Older Adults During COVID-19: A Strategic Approach for Strengthening Geriatric Care Across Health Systems

“…Hospital at home (HAH) is a concept that emphasizes on providing active treatment in the home environment of a patient who would otherwise need in-patient hospital care (Shepperd and Iliffe, 1998). Such services originated in the mid-twentieth century, which was increasingly adopted later by many healthcare organizations in the US, Canada, Netherlands, Australia, and the UK (de Sousa Vale et al, 2020;Shepperd and Iliffe, 1998). Under the HAH program, an emergency or community-level healthcare provider identifies a patient with a health problem and conducts an initial assessment using predetermined criteria to check if the patient needs hospitalization or if a 3 HAH care can effectively fulfill the needs for clinical care (de Sousa Vale et al, 2020).…”

“…Such services originated in the mid-twentieth century, which was increasingly adopted later by many healthcare organizations in the US, Canada, Netherlands, Australia, and the UK (de Sousa Vale et al, 2020;Shepperd and Iliffe, 1998). Under the HAH program, an emergency or community-level healthcare provider identifies a patient with a health problem and conducts an initial assessment using predetermined criteria to check if the patient needs hospitalization or if a 3 HAH care can effectively fulfill the needs for clinical care (de Sousa Vale et al, 2020). For example, a patient requiring surgical intervention may need acute care through hospitalization, but the post-operative and follow-up care can be delivered through HAH.…”

“…Thirdly, the autonomy and control over own health and associated decisions can be ensured within the home environment, which may contribute to better mental health and overall psychosocial wellbeing in older adults (Watkins et al, 2012). Lastly, in-patient care may provide acute medical or surgical care, but it clearly lacks a comprehensive approach, including psychological support, gerontological social care, and a wide range of community resources that can be delivered at doorstep rather than at the in-patient setting (de Sousa Vale et al, 2020;Watkins et al, 2012).…”

“…Despite a wide range of benefits of HAH in the COVID-19 pandemic, the adoption of such services can be challenging in diverse contexts (de Sousa Vale et al, 2020;Lafortune et al, 2015). Potential challenges may include: a) a lack of HAH services in healthcare organizations, b) inadequate access to HAH services for older adults, c) insufficient infrastructures, clinical resources, and healthcare providers to deliver HAH, d) a lack of community participation and adoption of HAH by the recipients, and e) policy-level barriers that may affect availability, accessibility, and utility of HAH by the older adults.…”

Hospital at home, an innovative approach in geriatric care during the COVID-19 Pandemic

“…Hospital at Home (HAH) is a concept that emphasizes on providing active treatment in the home environment of a patient who would otherwise requires in-patient hospital care [8]. Such services, originating in the mid-twentieth century,has been increasingly adopted by many healthcare organizations in the US, Canada, Netherlands, Australia, and the UK [8,9]. health status is achieved [10].…”