US model for hospital care at home reduces costs and increases patient satisfaction

Hot on the heels of the recent Deloitte/Access Economics report here in Australia, a study just published in the US also supports the potential of cost savings and increased patient satisfaction through greater utilisation on Hospital in the Home Services.

An innovative “hospital at home” acute care programme has reduced costs by 19% with similar or better clinical outcomes and increased patient satisfaction, an analysis has found. The programme combines daily home visits by doctors and nurses with telemedicine technology.

The ongoing programme at Presbyterian Healthcare Services in Albuquerque, New Mexico, was offered to those who met entry criteria, and a total of 582 patients (93%) enrolled between October 2008 and April 2012. It was adapted from a model developed at Johns Hopkins University.

“The savings were predominantly derived from lower average length of stay (3.3 v 4.5 days mean stay in hospital) and use of fewer lab and diagnostic tests compared with similar patients in hospital acute care,” the authors concluded in an analysis of the program for the calendar years 2009 and 2010.

Overall patient satisfaction was high in both settings, with mean scores of 90.7 and 83.9 respectively, as measured by a post discharge survey.

The telehealth unit allows instant communication with an offsite nurse24 hours a day, and provides basic tools of a blood pressure monitor, stethoscope, oximeter and glucometer that can be used under the nurses direction.

Bruce Leff, who spearheaded development of the “hospital at home” model at John Hopkins, said that they have learned some basic lessons from a variety of innovation collaborations in geriatric health. Among them are that all healthcare is local, and local conditions are of paramount importance in choosing the appropriate model. Technical assistance often is key to implementing a model.

This article was published in the June edition of the British Medical Journal (BMJ 2012;344:e3997).For a full copy please email anz@baxter.com