Brigham and Women's Hospital boosted inpatient capacity and access to care when providers treated acute patients at home, new research shows.
The Boston-based facility's hospital-at-home program treated 65 acutely ill patients over a three-month span during the COVID-19 pandemic, which freed up 419 inpatient beds, according to a Brigham and Women's study published Friday in the Journal of General Internal Medicine. Home hospital patients dealing with infections or complications associated with heart failure, chronic obstructive pulmonary disease or asthma received daily in-home or remote visits from attending general internists, two daily in-home visits from registered nurses and they had access to 24-hour physician coverage and remote monitoring tools.
"We know that home hospital programs can provide high-quality care for patients from the comfort of their home," Dr. David Levine, a general internist at Brigham and lead author of the study, said in a news release. "Our study shows that this model can also be effective during a pandemic to free up hospital beds during a surge by treating non-COVID patients at home."
While the study doesn't compare outcomes, researchers referenced previous analyses that found hospital-at-home programs had similar quality, safety and experience metrics compared to traditional hospital care. The length of stay for the patients in the new study was five days and 12.3% were readmitted within 30 days.
Home hospital care is about 38% less expensive than traditional inpatient treatment and is far more efficient and cost effective than improvised filed hospitals, the study says.
Brigham and Women's hospital physicians limited their analysis to two sites, a small cohort of clinicians and to the pandemic conditions in Boston.
More than 145 hospitals started home hospital care after CMS expanded a temporary payment model in November 2020, the researchers wrote.
Mayo Clinic and Kaiser Permanente, for instance, recently invested $100 million in Medically Home as they map out a national blueprint for complex in-home care.
"Home hospitals may represent a key response mechanism for a pandemic, but there's also great evidence for their use when there isn't a pandemic—patients have good outcomes, and they report great experiences receiving care at home," Levine said.
