New Hospital-at-Home Care Model Tied to Better Outcomes

Shorter length of stay, lower rates of readmission, ER revisits than inpatient hospitalization

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TUESDAY, June 26, 2018 (HealthDay News) -- Hospital-at-home (HaH) care, along with 30-day post-acute transitional care, is associated with better patient outcomes and satisfaction with care than inpatient hospitalization, according to a study published online June 25 in JAMA Internal Medicine.

Alex D. Federman, M.D., M.P.H., from Icahn School of Medicine at Mount Sinai in New York City, and colleagues performed a case-control study to report outcomes of a new payment model for HaH care that bundles acute episodes with 30 days of postacute transitional care. Data were included for 295 HaH patients age 18 years and older with acute medical illness requiring inpatient-level care and 212 control patients who met HaH eligibility but received inpatient care.

The researchers found that HaH patients were older than controls and more likely to have a preacute functional impairment. Length of stay was shorter for HaH patients (3.2 versus 5.5 days), and they had lower rates of readmissions (8.6 versus 15.6 percent), emergency department revisits (5.8 versus 11.7 percent), and skilled nursing facility admissions (1.7 versus 10.4 percent). They were also more likely to rate their hospital care highly (68.8 versus 45.3 percent).

"HaH care bundled with a 30-day postacute transitional care episode was associated with better patient outcomes and ratings of care compared with inpatient hospitalization," the authors write. "This model warrants consideration for addition to Medicare's current portfolio of shared savings programs."

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