BALTIMORE—Using a Johns Hopkins-developed program that allows medical professionals to provide acute hospital-level care within a patient’s home, a New Mexico health system was able to reduce costs by roughly 20 percent and provide equal or better outcomes than hospital inpatients, according to new research.
“Hospital at Home is an excellent model of care that can be implemented in a practical way by health delivery systems across the country and can have dramatic positive clinical and economic outcomes for patients and systems," said Bruce Leff, MD, the Johns Hopkins professor who developed the Hospital at Home model and leader of a study published in the June issue of the journal Health Affairs. “This program represents what health care reform is attempting to achieve; it’s a high-quality clinical program that provides patient-centric individualized care while making the most effective and efficient use of the healthcare dollar."
The yearlong study involved 323 patients who were sick enough to require hospitalization, but who instead opted for care through the Hospital at Home program. They compared those patients with 1,048 hospital inpatients. For both groups, patients were elderly, mostly female and white, and the most common diagnosis was pneumonia.
All Hospital at Home patients in the study met validated medical eligibility criteria to ensure patient safety and lived in a residence within a 25-mile radius of an emergency department run by Presbyterian Healthcare Services of Albuquerque, N.M. Physicians visited each patient daily for medical care, diagnosis and care plan coordination.
Depending on the patient’s condition, nurses would visit once or twice daily to assess the patient and administer infusions and other medications, conduct routine lab tests, perform ordered care procedures, teach patients and families about managing their medical condition, and prepare them for eventual discharge and transition. The physician visited the patient at home daily. The patients in the study were diagnosed with a variety of health problems, including recurring congestive heart failure, cellulitis, deep vein thrombosis, pulmonary embolism, urinary tract infection, nausea, vomiting and dehydration.