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Home From Hospital !FULL!

Home From Hospital -

Home From Hospital !FULL!

If you have questions about home care for yourself or a loved one, we are here to help - even on short notice. In fact, we have a registered nurse on call 24-hours a day. Contact Home & Hospital Medical Personnel to learn more.

As hospitals reconsider how and where they deliver care to patients, many are seeing the hospital-at-home model as a promising approach to improve value. Hospital-at-home enable some patients who need acute-level care to receive care in their homes, rather than in a hospital. This care delivery model has been shown to reduce costs, improve outcomes and enhance the patient experience.

Members In Action: Atrium HealthIn response to the COVID-19 pandemic, Atrium launched a two-unit virtual hospital to free up hospital beds for the most complex patients and allow for some COVID-19 patients to recover in their homes, thus limiting community spread and stretching their capacity.

Members In Action: Brigham HealthThrough its home hospital program, Brigham Health patients receive hospital-level care in the comfort of their own homes. Patients in the program experienced fewer clinical interventions, more physical activity and comparable patient satisfaction scores as those being cared for in the hospital. The program has also helped lower costs and readmissions.

Interested in starting a hospital-at-home program Get practical advice from HaH leaders in this webinar series that covers all aspects of implementing a HaH program. The webinars are part of our partnership with the Hospital at Home Users Group and the American Academy of Home Care Medicine. View the archives or register for upcoming webinars here.

Instituting this type of substitution in the U.S. could produce dramatic savings for the Medicare program and private payers, chiefly by eliminating the fixed costs associated with operating a brick-and-mortar hospital. Indeed, pilots of the model have already achieved savings of 30 percent and more per admission, while delivering equivalent outcomes and fewer complications than traditional hospital care.3 In addition to such savings, at-home care may also help avoid shortages of beds in U.S. hospitals.

The Johns Hopkins Model Johns Hopkins developed its hospital at home program as a means of treating elderly patients who either refused to go the hospital or were at such risk of hospital-acquired infections and other adverse events that physicians kept them at home out of concern for their safety. Early trials of its model (described in the box above) found the total cost of at-home care was 32 percent less than traditional hospital care ($5,081 vs. $7,480), the mean length of stay for patients was shorter by one-third (3.2 days vs. 4.9 days), and the incidence of delirium (among other complications) was dramatically lower (9% vs. 24%).4 One study of the program also found no difference in rates of subsequent use of medical services or readmissions. And patients and family members' satisfaction was higher in the home setting than among those offered usual hospital care, reflecting the convenience of the model.

Payment a Significant Barrier Despite these dramatic results and the refinement of portable imaging equipment and drug delivery systems that facilitate home-based care, the dissemination of the model in the U.S. has been slowed by lack of payer acceptance. By contrast, the state government in Victoria, Australia, reimburses for at-home care at the same rate it reimburses for inpatient care. Without that "hospitals would not be engaged enough to bother," says Michael Montalto, M.D., Ph.D., director of the "Hospital in the Home" program at both Royal Melbourne Hospital and Epworth Hospital. (In Australia, the state derives a financial benefit from reducing or eliminating the need to build new hospitals as demand for acute care increases.)

The Clinically Home model was designed in collaboration with Johns Hopkins (Leff serves as chair of the company's clinical advisory boar


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