Several hospitals in the United States are starting to admit some elderly patients to the hospital, but in their own homes. It is called the hospital-at-home model and a recent study found that it was a safe way in which some patients could be treated effectively.
Keeping elderly patients out of the hospital can help them stay in their own homes and stay out of nursing homes. Being in a hospital can put elderly patients at risk for serious infections, and can be emotionally upsetting for them and their families. An elderly person can develop delirium and become physically weakened by a stay in the hospital, which can lead to needing to move to a nursing home.
A hospital-at-home program provides treatments like intravenous fluids and medications and even x-rays and ultrasounds in the patient's home. The program is best suited for conditions that can be treated by technology that can be brought to the home and for patients who might need hospitalization but do not need intensive care. Doctors and nurses visit the patient daily. The patient is in familiar surroundings and can be with family and friends.
The study followed 455 elderly patients who had pneumonia, problems with chronic heart failure, problems with chronic obstructive pulmonary disease, or bacterial skin infections. They were seen at three acute-care hospitals and a Veterans Administration medical center and were offered the choice of being treated at home instead. At two sites, 69% of the patients chose to be treated at home, and 29% chose at-home care at the third site.
Patients who were treated in the hospital-at-home model had a shorter average "stay" than those admitted to a hospital; 3.2 days compared to 4.9 days. There was some evidence that they had fewer complications. The costs for treatment at home averaged about $2,400 less than for the hospital.
Although less procedurally oriented than acute hospital care, hospital-at-home care met quality standards at rates similar to those of acute hospital care, the study noted.
The study can be read at http://well.blogs.nytimes.com/2015/04/27/admitted-to-your-bedroom-some-hospitals-try-treating-patients-at-home/?ref=health. You can read more about the hospital-at-home model at http://www.hospitalathome.org/.
