The Home Hospital: What Is It and How Will It Affect Future Care?

As the general population continues to age and live longer, the healthcare system will face increased demands on its services. Long-term chronic health problems as well as ongoing acute care will stress an already over-taxed system.

There has already been a significant shift from inpatient to outpatient procedures as well as shorter in-hospital recovery times to address some of these issues.

Patients often prefer to recover at home when possible, minimizing the cost of hospital stays and exposure to other illnesses. Individuals are often more comfortable at home, surrounded by loved ones, familiar food and routines, and their own belongings.

In addition, the development of remote monitoring technologies that are able to be affordably used in the home while keeping healthcare providers abreast of a patient’s vital signs and recovery from afar will also facilitate a shift to a home-based hospital.

What is a Home Hospital?

A home hospital is a service model that seems to work best for older patients who use the healthcare system extensively and require acute hospital-level care on an ongoing basis.

According to an article in Today’s Geriatric Medicine, “Studies have reported that treating acutely ill older adult patients diagnosed with conditions such as congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) at home rather than in a hospital has many benefits. Hospital at Home has resulted in lower costs, shorter duration of hospital-equivalent treatment, fewer procedures, reduced geriatric complications, improved activities of daily living, and better patient and caregiver satisfaction.”

Bruce Leff, MD, developed the Hospital at Home model and is a geriatrician and professor of medicine at Johns Hopkins University in Baltimore. He also stated that “Hospital at Home has been well studied. A new meta-analysis in the Medical Journal of Australia found a 24% reduction in readmissions for Hospital at Home and about a 20% reduction in mortality, which is really quite remarkable.”

Home hospitals will not be a replacement for conventional hospitals, but an additional way to provide care to a specific group of patients who will benefit most.

What Will Future Care Look Like?

Given that initial research has already shown that a home hospital model can be beneficial to both patients as well as the entire healthcare system, it’s interesting to consider what this could mean for future care.

The Deloitte Center for Health Solutions decided to explore the issue with a crowdsourcing simulation that involved 33 experts including executives, physicians, nurses, policy leaders, and futurists from around the world. The simulation resulted in expected developments in five key categories:

• Care Delivery. Technology will allow continuous clinical monitoring through portable devices as well as more targeted treatments such as using 3D printing for surgeries.
• Digital Experience. Artificial intelligence (AI) and machine learning technologies can facilitate on-demand conversations and more seamless interactions for the patient.
• Better Documentation and Training. AI technologies can also take the documentation burden off healthcare providers, allowing them to provide more direct care as well as streamline training for new practitioners.
• Back-Office Efficiencies. Tools such as automation and robotics as well as digital supply chains can improve operations management and efficiency.
• Focus on Well-Being. By considering the best environment for healing and well-being of both patients and healthcare providers, home hospitals have the potential to significantly improve care.

An Expected Economic Shift for Providers

Besides being a beneficial solution for patients, especially the elderly living with long-term chronic conditions, the home hospital offers economic advantages for hospitals as well.

According to Deloitte, most care will be “delivered at home, or through virtual, outpatient, and other settings” by 2040. In addition, there will be a significant shift to more wellness and prevention strategies instead of waiting for illness and sickness to progress to treatment stages. This shift is another way to reduce the burden on the overall healthcare system.

Another Deloitte study looked at how healthcare systems were planning and investing for the future of home hospitals and related outpatient care. The report found that “between 2011 and 2018, hospital outpatient revenue grew at a higher compounded annual rate compared to inpatient revenue while the aggregate outpatient share of total hospital revenue grew from 28 percent in 1994 to 48 percent in 2018.”

Technology has played a big role in this shift, including digital consumer apps, virtual health tools, and predictive analytics. This is expected to continue in upcoming years as additional home hospital services rise.

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