Presbyterian Healthcare Services initiated a Hospital at Home program  in New Mexico; one which was devised by investigators at Johns Hopkins in 2008.

The premise is that:

  • Most people would prefer to recover at home in contrast to a traditional hospital
  • Home care is cheaper
  • Home care is safer

Researchers found that it was cheaper indeed- 19% less than those treated in the hospital.  Clinical outcomes were the same or better for the patients recovering at home.

Additional benefits to come out of the study led by Lesley Cryer, RN, executive director of the Home Healthcare Division of Presbyterian Healthcare Services were:

  • Lower mortality rate (.93% vs. 3.4%
  • Lower fall rate (0 vs. .8%)
  • Shorter recovery rate (1.2 days less on average)

Requirements to enroll into the program included the patient location- home must be within 25 miles of an emergency department.

Chronic medical conditions evaluated:

  • Cellulitis
  • Deep vein thrmobosis
  • Urosepsis (severe urinary tract infection)
  • COPD (chronic obstructive pulmonary disease)
  • Congestive heart failure
  • Walking pneumonia
  • Dehydration
  • GI symptoms
  • Health Affairs just published a study in its June issue that generic ventolin 100 mcg inhaler examined a “hospital at Home” model.

Each patient was visited by nursing staff once or twice daily and a physician was available 24/7 for emergencies. Telehealth units were also erected in the home with pulse and blood pressure monitors, glucometer and patient ability to speak with nurses via video systems.

The study published in the June issue of Health Affairs reports that there was a 38% reduction in mortality at 6 months and 19% lower costs, much of it due to less frequent lab testing. Not surprisingly, 90% of patients had a much greater satisfaction with the recovery. (as opposed to 83%). Funnily enough, home recovering patients complained about the food more!

The drawback with setting up these patient-centric programs in many hospitals centers around payment.  While the cost is less for home recovery, Medicare and many third party payers, do not reimburse for home recovery, only  fee-for-service treatment in hospitals.

Perhaps it is time for this to change!