Introduction
Hospital-at-home services have grown in popularity, especially during the COVID-19 epidemic, as hospitals struggle with high ICU bed occupancy and infection rates. Patients may obtain medical treatment at home using hospital-at-home services. Despite some uncertainty and doubts about the effectiveness of hospital-at-home programs, the need for home-based care services has increased due to rising healthcare costs that could further burden institutionalized patients and the growing number of elderly patients with health needs.
This research does a brief literature assessment of US hospital-at-home programs, focusing on their benefits and drawbacks. The context will discuss Hospital-at-home programs’ enhancement to patient outcomes, healthcare costs, and patient happiness. It will next discuss the constraints of hospital-at-home programs, such as the requirement for specific equipment and personnel, restrictions in patient health monitoring, and patient selection concerns.
Opportunities for hospital-at-home programs
Hospital-at-home programs provide medical treatment and assistance to patients in their homes, offering a viable alternative to regular hospital care. These initiatives are a great deal in helping people and healthcare practitioners. Moreover, Hospital-at-home programs provide greater patient outcomes, lower healthcare costs, and more patient satisfaction, which we shall address in this section.
Firstly, Hospital-at-home initiatives increase patient outcomes. Homecare patients are less likely to develop hospital-acquired infections, falls, and adverse drug responses than hospitalized patients (Schiff et al., 2022). Moreover, Early release from hospital-at-home programs minimizes hospital-related problems and readmissions (Guinan & Painchaud, 2022). Hospital-at-home programs also enhance functional outcomes in older persons with acute medical illnesses, such as daily activity (Leff et al., 2022).
Secondly, Hospital-at-home initiatives may also lower healthcare expenses. Hospital-at-home programs decrease overhead expenses like room and board and limit the need for costly medical equipment, making them a cost-effective alternative to standard hospital treatment (Brody et al., 2022). Pericàs et al. (2021) say this initiative may save healthcare expenses by 50%. This cost decrease is accomplished by delivering care at the patient’s home, cheaper than hospital care.
Lastly, Hospital-at-home initiatives may also improve patient satisfaction. Patients choose home treatment to minimize hospital stress and stay in a familiar setting (Levine et al., 2021). Hospital-at-home programs allow patients to spend more time with their doctors, improving communication and trust (Brody et al., 2022). Moreover, Hospital-at-home programs may also influence patients more on their healthcare choices, improving their satisfaction with treatment.
In general Hospital-at-home programs provide many chances to improve patient outcomes, reduce healthcare costs, and increase patient happiness. Hospital-at-home programs minimize many downsides of conventional hospital treatment, such as hospital-acquired infections and high overhead expenses, by delivering care in the patient’s home. Hospital-at-home programs provide a viable alternative to regular inpatient therapy as healthcare expenses grow.
Challenges of hospital-at-home programs
Hospital-at-home programs provide many benefits, but they can have drawbacks. These may include; requirements for specialist equipment and personnel, restrictions in monitoring patient health conditions, and patient selection concerns.
Specialized equipment and personnel are major hurdles for hospital-at-home programs. Hospital-at-home programs require healthcare practitioners to bring medical equipment to the patient’s house. This may be difficult in rural or distant places where medical equipment is few (Levine et al., 2021). Moreover, Hospital-at-home programs need nurses and doctors educated in-home care (Brody et al., 2022); recruiting and maintaining experienced healthcare providers willing to work in a home-based setting might be challenging since many prefer the hospital atmosphere.
Hospital-at-home programs have trouble monitoring patient health. Traditional hospital treatment involves constant monitoring and a variety of diagnostic tests and procedures. However, hospital-at-home programs may not provide the same degree of monitoring or fast access to diagnostic tests and treatments (Leff et al., 2022). This makes it harder for doctors to spot and treat patient changes. Some tests and treatments need patients to go to a hospital or clinic, which may be inconvenient and expensive.
Patient selection is another issue with hospital-at-home programs. Hospital-at-home programs do not work for everyone. Traditional hospitals may be preferable for patients with complicated medical disorders or needing intense monitoring and intervention (Guinan & Painchaud, 2022). In other words, Hospital-at-home programs may not work for patients who live alone or do not have a support system. Also, Hospital-at-home programs may not accept patients without a safe and pleasant home setting.
Lastly, Healthcare personnel and patients must communicate well in hospital-at-home programs. Effective communication is necessary to ensure that patients get the right treatment and support and to address any issues or problems that may emerge throughout the hospital-at-home program (Levine et al., 2021). Patients must understand and follow their care plan to get proper therapy and monitoring. Patients with little health literacy or who speak a language other than English may find this difficult.
Hospital-at-home initiatives improve patient care and lower healthcare expenses in general. They also pose many issues that must be handled. These problems include the requirement for specialized equipment and personnel, restrictions in monitoring patient health status, concerns with patient selection, and the necessity for good communication between healthcare practitioners and patients. Hospital-at-home programs must overcome these obstacles to provide high-quality, cost-effective treatment to patients.
The current state of hospital-at-home programs in the United States
To fully comprehend their potential effect and spot opportunities for development, it is crucial to thoroughly review hospital-at-home programs as they now exist in the United States.
Leff et al. (2022) report that hospital-at-home programs are becoming more popular as an alternative to hospitalization. These programs address heart failure, COPD, pneumonia, and cellulitis. Hospital-at-home programs work well for low-acuity patients who don’t need rigorous monitoring or intervention. Additionally, Pericàs et al. (2021) discovered that older persons with mild to moderate symptoms made up most of the population treated with hospital-at-home programs for COVID-19. According to the authors, hospital-at-home programs worked best for patients with strong support networks who could adhere to the suggested treatment and monitoring regimens.
Program-specific healthcare systems and providers are used in hospital-at-home programs to give care. According to Brody et al. (2022), various healthcare institutions, including home health companies, hospital systems, and managed care organizations, may conduct hospital-at-home services. The authors also point out that urban and rural communities may establish hospital-at-home programs.
Recent regulatory and legislative developments have altered the utilization of hospital-at-home programs in the US. According to Schiff et al. (2022), the COVID-19 pandemic has raised interest in and investment in hospital-at-home programs, and several states and healthcare systems have started adopting them. The authors also point out that recent modifications to Medicare’s payment guidelines have made it simpler for medical facilities to deliver hospital-at-home services.
Lastly, Hospital-at-home services are now being expanded and improved. Leff et al. (2022) point out the necessity for ongoing studies on the efficacy and effects of hospital-at-home programs and the creation of best practices for putting these programs into action in a fair and sustainable way. In hospital-at-home programs, Brody et al. (2022) also advocate a change toward person-centered solutions, emphasizing individualized patient care tailored to their needs and preferences.
Looking to the future, Emerging technology and ideas might enhance hospital-at-home services. Telemedicine and remote monitoring may address hospital-at-home program issues, including ongoing patient monitoring. Remote monitoring technology may enhance patient outcomes and save healthcare costs by monitoring patient health more often and accurately, according to Leff et al. (2022). Additionally, Hospital-at-home programs may potentially be incorporated into healthcare delivery systems due to technology improvements. According to Brody et al. (2022), hospital-at-home programs provide patient-centered, individualized treatment. Integrating hospital-at-home programs into larger healthcare systems may help create more patient-centered and equitable systems. Future studies should improve hospital-at-home programs and integrate them into healthcare delivery systems. Hospital-at-home programs may improve healthcare quality, efficiency, and equity by using new technology and supporting patient-centered care.
In summary, the present situation of hospital-at-home programs in the United States is marked by rising use, diverse demographics, and various healthcare professionals and systems participating in delivery. Hospital-at-home programs are now being expanded and improved despite recent legislative and regulatory changes influencing their utilization.
Literature review
With the COVID-19 epidemic, US hospital-at-home literature has grown significantly. This section summarizes the publications’ results and discusses how they help us comprehend US hospital-at-home programs.
Guinan and Painchaud (2022) examined hospital-at-home programs on health inequalities. Hospital-at-home programs may minimize healthcare inequalities by delivering high-quality treatment to underrepresented groups, including minorities, low-income people, and rural communities. Hospital-community collaborations increase hospital-at-home program access, according to the authors. Additionally, Schiff et al. (2022) investigated COVID-19 hospital-at-home programs. They claimed that hospital-at-home programs might help reduce COVID-19 by offering patients a safe and effective alternative to hospital treatment. The authors also suggested a further study on hospital-at-home programs’ long-term effects on patient outcomes and healthcare expenditures.
Secondly, Leff et al. (2022) proposed hospital-at-home research. They suggested studying patient selection criteria, staffing methods, and hospital-at-home program integration with other healthcare services. The authors emphasized patient-centered care in hospital-at-home program creation and execution. Moreover, Brody et al. (2022) recommended permanent, person-centered solutions for US hospital-at-home programs. Hospital-at-home programs might change US healthcare but require more funding and innovation to be sustainable and successful. Moreover, the author stresses Hospital-at-home programs need specific equipment and personnel.
Qualitative research by Levine et al. (2021) examined rural views of acute home care. Rural patients and healthcare professionals like hospital-at-home programs, but the authors observed significant challenges to their adoption. These included a lack of medical equipment, specialist personnel, and bandwidth for telehealth services. Lastly, Pericàs et al. (2021) reviewed Spain’s COVID-19 hospital-at-home programs. Hospital-at-home initiatives reduced hospitalization and improved patient outcomes. Compared to hospitals, they saved money. However, hospital-at-home programs’ long-term effects on patient outcomes and healthcare expenditures require additional study.
In general, the articles discuss the benefits and drawbacks of US hospital-at-home programs. Hospital-at-home programs may improve patient outcomes, save healthcare costs, and boost happiness. They also note the requirement for specialist equipment and people, constraints in patient health monitoring, and patient selection concerns. The articles also advocate for further study on the long-term effects of hospital-at-home programs on patient outcomes and healthcare expenditures and creative solutions to their issues. The literature suggests that hospital-at-home programs could revolutionize US healthcare, but they need more investment and innovation to be sustainable and effective.
Conclusion
A promising alternative to standard hospital treatment, hospital-at-home programs may enhance patient outcomes, save healthcare costs, and boost patient satisfaction. Even though these projects face difficulties, including the need for specialized resources like employees and equipment, continuous research and development initiatives might provide answers. According to the results of a literature analysis, hospital-at-home programs are being used more often in the United States, and healthcare systems and providers are helping to offer them. The growth of hospital-at-home programs has also been made easier by recent legal and legislative reforms, notably in reaction to the COVID-19 epidemic. Going ahead, tailoring treatment to the needs and preferences of specific patients may be accomplished by establishing and upgrading hospital-at-home programs with an emphasis on person-centered solutions. Research and development are required to execute these initiatives sustainably and equitably. Hospital-at-home initiatives may make healthcare more patient-centered, egalitarian, and sustainable.
References
Brody, A. A., Dorfman, E., Caspers, C. G., & Sadarangani, T. R. (2022). What’s next for Hospital at Home Programs in the United States: A clarion call for permanent, person‐centered solutions. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.18089
Guinan, M., & Painchaud, A. (2022). Essential Hospitals Advance Equity Through Hospital-At-Home Model. Policy.
Leff, B., DeCherrie, L. V., Montalto, M., & Levine, D. M. (2022). A research agenda for the hospital at home. Journal of the American Geriatrics Society, 70(4), 1060-1069.
Levine, D. M., Desai, M. P., Ross, J., Como, N., & Anne Gill, E. (2021). Rural perceptions of acute care at home: a qualitative analysis. The Journal of Rural Health, 37(2), 353-361.
Pericàs, J. M., Cucchiari, D., Torrallardona-Murphy, O., Calvo, J., Serralabós, J., Alvés, E., … & Hospital Clínic 4H Team (Hospital at Home-Health Hotel). (2021). Hospital at home for the management of COVID-19: preliminary experience with 63 patients. Infection, 49, 327-332.
Schiff, Rebekah, et al. “Hospital at Home: Another piece of the armory against COVID-19.” Future Healthcare Journal 9.1 (2022): 90.
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