Evaluating Domestic Feasibility of Hospital-at-Home Programs
With many hospitals throughout the world overflowing due to COVID-19, healthcare providers have started searching for ways to reduce the patient load. While hospital-at-home programs emerge as a short-term solution for effectively treating patients while freeing up crucial hospital space, they can provide a myriad of long-term benefits as well. Yet despite the positives of the hospital-at-home model, healthcare professionals may continue to encounter resistance when attempting to expand hospital-at-home efforts within the United States.
While select institutions throughout the United States, including Johns Hopkins and the Mayo Clinic, use the hospital-at-home model, it continues to be a relative novelty across most of the US1,2. However, the domestic infrequency of the hospital-at-home model is in sharp contrast to its integration in other healthcare systems around the world; indeed, countries such as England, Canada, Israel, and Australia have all used the hospital-at-home model for years with high levels of success. More specifically, studies show that countries which have implemented hospital-at-home programs allow patients to receive top-notch care from healthcare professionals; one report finds that 60% of patients with deep venous thrombosis in Australia are now treated via hospital-at-home programs instead of through traditional in-patient care2.
During today’s ongoing pandemic, the hospital-at-home model offers an opportunity to move patients back home in order to reserve critical hospital space for those who need it most. At the same time, large-scale hospital-at-home efforts offer the long-term possibility of changing the healthcare system. The hospital-at-home program has been shown to improve the quality of patient care, as more patients show improved recovery from hospital-at-home treatments than they do in traditional in-patient care facilities3. In addition, the hospital-at-home model can drastically expand the accessibility of healthcare as well. Pilot programs in the United States show healthcare costs could be reduced by 30% through transitioning patients out of hospitals, which highlights the affordable nature of such a model2.
However, this model still faces an uphill battle for mainstream integration in the United States. Many have voiced concerns about both the continued effectiveness and legal risks of the hospital-at-home method. Moreover, payer acceptance remains a key obstacle for widespread American use of the hospital-at-home model, with most private payers expressing reluctance to pay for at-home hospital care. In particular, covering costs for telemedicine – which is considered a crucial component of hospital-at-home programs – is restricted to very select cases, blocking broader implementation of this approach2.
The hospital-at-home model is used worldwide and has the potential to revolutionize patient care. Already, institutions in the United States, such as Johns Hopkins Medicine, are advocating for such programs as well. However, questions surrounding treatment and private payer hesitance remain barriers to normalizing the hospital-at-home model in the US. As such, while external pressures from COVID-19 may drive more healthcare professionals to seriously consider a larger movement towards hospital-at-home programs, only time will tell if such a change will be embraced across the nation.
References
[1] Kacik, A. (2020, June 25). Mayo Clinic to launch national hospital-at-home model. Retrieved July 09, 2020, from https://www.modernhealthcare.com/operations/mayo-clinic-launch-national-hospital-home-model [2] Klein, S. (n.d.). “Hospital at Home” Programs Improve Outcomes, Lower Costs But Face Resistance from Providers and Payers. Retrieved July 09, 2020, from https://www.commonwealthfund.org/publications/newsletter-article/hospital-home-programs-improve-outcomes-lower-costs-face-resistance [3] Famakinwa, J. (2019, October 01). Hospital-at-Home Models, Home Health Partners Primed to Disrupt US Health Care System. Retrieved July 09, 2020, from https://homehealthcarenews.com/2019/10/hospital-at-home-models-home-health-partners-primed-to-disrupt-us-health-care-system/