As a way to protect patients from infections that spread in hospitals, some hospitals in New York and New Mexico are starting to offer hospitalization at home. The arrangement includes daily visits from doctors and nurses as well as at-home lab draws, medication, x-rays, and even ultrasound scans if needed. The cost of this at-home care is typically no greater than if the patient received care at a hospital instead.
Before such programs were put to the test, health care organizations first had to determine what conditions could be treated with technologies at home. One program, Hospitals at Home, offered this option to patients who required hospitalization but not intensive care. Ultimately, this program determined four diagnoses that could be treated at home: emphysema, certain types of pneumonia, a skin infection called cellulitis, and heart failure.
According to a New York Times article from April of this year, the overall intent of hospitalization at home is to “reduce cost while improving quality.” Patients who agree to be treated at home benefit from increased comfort and satisfaction, since they no longer regulated have curfew or visitor hours. They are also allowed to wear their own clothes and eat their own food. Another benefit of home care is that patients at home are hospitalized for a shorter amount of time, and most of them do not have to be readmitted for the same condition. Also, when at-home patients are discharged from the hospital, they are conveniently already at home.
However, nurses and doctors need to educate at-home patients so that medication and equipment are not mishandled. Many doctors believe this is more manageable.“I’m a doctor. I can talk to a patient, I can examine a patient, I can bring home oxygen and IV meds and fluids, I can do home X-rays. I can do quite a bit,” said Dr. Bruce Leff, a geriatrician and professor of medicine at Johns Hopkins. “We felt that it could be done, and the hypothesis was that by doing so, we could reduce harm,” he added.
Patients with worrisome vital signs like high heart rate and low blood pressure may not have the choice to be hospitalized at home, however. Also, patients can be rejected if they do not have electricity, running water, or enough space to put the required equipment at home. Further, if the condition being treated at home worsens, the patient will have to be moved to a hospital. Additionally, some patients reject the opportunity for at-home care because they do not like the idea of having strangers in their private space, or because they own pets that could damage the equipment. Yet, most patients agree to be hospitalized at home.
Even though at-home care programs are gaining popularity, most insurance plans do not currently cover in-home services. But patients and doctors both hope that in the near future, hospitals will provide only high-tech care, while most medical services can be done at home. This trend would likely reduce the cost of hospitalization and ultimately increase patient satisfaction.
[Source: The New York Times]