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Home Skilled Nursing

First Ever ‘Home Hospital’ Random Trial Reveals Surprising Results

Acute Care Episodes, Costs Halved

Bob Thomson by Bob Thomson
March 5, 2018
in Home Care, Nursing Homes, Senior Health, Skilled Nursing, Telehealth
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Home Hospital Pilot Medpage Today
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I think most people in the elder care field agree that delivering care in a senior’s home is the preferred modality when given a choice of facility vs home. It just makes sense. Here’s a brand new study, the first of its kind, to add more evidence to the mounting argument of why home care rules…

When it comes to patients’ healing, few places can beat home, with its comforts and sense of familiarity. That’s why, in recent years, hospitals have done what they can to make their campuses feel more homelike, with amenities such as private rooms, soundproofing, healing gardens, massage therapy services, and gourmet food.

But a small pilot study published in the Journal of General Internal Medicine has turned the idea of feeling at home at the hospital on its head. Instead, it brought the hospital to patients’ homes and saved money in the process. “We believe that people can heal from an acute illness in their home, and we want to show that this can be done in a high-quality, safe, cost-effective manner,” said the study’s principal investigator, David Levine, MD, MPH, MA, of Brigham and Women’s Hospital in Boston and an instructor in medicine at Harvard Medical School. “This is the first time a randomized controlled trial of home hospital has been performed,” he noted.

Here is a snapshot of the study’s results…

The patient experience was similar in both groups, but other results showed key differences, the researchers reported.

“Cost and utilization were significantly less for those who were home hospitalized,” said Levine. “For example, cost was about half for those at home compared to those in the traditional hospital. Those at home also had significantly more physical activity.”

The main results were as follows:

  • The median direct cost of the acute care episode for home patients was 52% lower than for control patients
  • Home patients also had fewer laboratory orders (median per admission: six versus 19) and less often received consultations (0% versus 27%)
  • Home patients were more physically active (median minutes, 209 versus 78), with a trend toward more sleep
  • No adverse events occurred among the home patients, whereas one occurred among the control patients
  • The median direct cost for the acute care plus 30-day post-discharge period for home patients was 67% lower, with trends toward less use of home-care services (22% versus 55%) and fewer re-admissions (11% versus 36%)

Full article at‘Home Hospital’ Pilot Halves Acute Care Episode Costs

It’s interesting to note that all things being equal between the home hospital scenario and the setup in the hospital, patient recovery was better and re occurrences declined in the home hospital environment. Sleep and activity times both increased at home. I think it’s logical to conclude that there is a synergistic effect on healing when someone does so in the comforts of home. Less stress, more sleep and activity yields faster healing.

thumbnail courtesy of medpagetoday.com

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