“Hospital care is not ideal for many older patients,” said Bruce Leff, MD, lead author of the study and associate professor at The Johns Hopkins University School of Medicine. Many patients perceive hospitals as cold, lonely, unfortunate places filled with disease and sadness. Not the ideal place to fully recover and return to daily life. That is why Johns Hopkins began a study to test hospital level care- at home. The original study was conducted at hospitals in Buffalo, NY, Worcester, MA, and Portland, OR with patients 65 years of age or older, who needed treatment for four common age related conditions: pneumonia, chronic heart failure, chronic obstructive pulmonary disease, and cellulitis. Each patient was able to choose which form of care they wished to receive- at home or in the hospital.
According to the study, the Hospital at Home program reduced mortality and readmission rates all while raising patient satisfaction rates by 10 percent. The study was also able to lower patient costs by shortening their hospital stays and using fewer lab diagnostic tests than their counterparts who opted for the hospital stay.
This program offers many different benefits to all parties involved. Sick patients are able to recover in the comfort of their own home; they don’t have to worry about contracting other infections, noisy roommates, or any of the other unpleasantries that come with hospital stays. Patients still see their doctors and nurses just as much as they would if they were staying in the hospital, and in some cases receive even more face time. Hospital at Home also makes it easier for family and friends to visit a patient, which in turn can help them recover and get back to their daily life at an even faster pace.
While this program sounds ideal, there are limitations. All the patients in the study lived within a 25 mile radius of the hospital, which makes this type of treatment nearly impossible for patients not living near a local hospital. There is also the assumption by some that hospital stays are safer than at home care. Then there is the problem with Medicare. “Currently, there are no payment codes for Hospital at Home care in fee-for-service Medicare,” said Leff. Meaning, for the time being, Hospital at Home care is reserved for Medicare managed care and Veterans Affairs health systems, who have patients living no more than 25 miles away from the hospital. I look forward to seeing how this program evolves to operate on a larger scale and to fit the needs of every patient who opts for Hospital at Home care.
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