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Study: Hospital-at-home might be good for some acutely ill people at ED

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Med Page Today reports:

“Hospital-at-home (HaH) care may be a good replacement for traditional inpatient services among some patients who arrive at the emergency department (ED) with an acute condition, a health system reported.

“In 2014, the Icahn School of Medicine at Mount Sinai in New York City was given a Health Care Innovation Award by the Centers for Medicare & Medicaid Services to demonstrate the clinical effectiveness of HaH care bundled with a 30-day postacute period of home-based transitional care. Since then, the institution’s Albert Siu, MD, MSPH, and colleagues observed that several measures did favor HaH care over inpatient hospitalization:

  • “Acute period length of stay: 3.2 versus 5.5 days (weighted P<0.001)
  • “All-cause 30-day hospital readmissions: 8.6% versus 15.6% (weighted P<0.001)
  • “ED revisits: 5.8% versus 11.7% (weighted P<0.001)
  • “Admissions to skilled nursing facilities: 1.7% versus 10.4% (weighted P<0.001)
  • Rating their hospital care highly: 68.8% versus 45.3% (weighted P<0.001)

“Yet rates of referral to a certified home healthcare agency yielded no difference between groups, Siu’s group reported online in JAMA Internal MedicineEven so, they maintained that that their findings justify creation of a new payment model within Medicare’s current portfolio of shared savings programs.”

To read the entire Med Page Today article, please hit this link.

To read the stud in JAMA InternaL Medicine, please hit this link.



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