A hospital stay can be stressful and disruptive for both the patient and their loved ones. But what if hospital-level care could be delivered safely in the comfort of your own home? An innovative model known as hospital at home (HAH) is allowing eligible patients to receive certain acute medical care at home instead of being admitted to a traditional hospital.
What is ‘hospital at home’?
Hospital at home is exactly what it sounds like: Instead of staying overnight in a hospital, eligible patients receive hospital-level treatment in their own homes while remaining under the care of a participating hospital.
Services may include physician visits, skilled nursing care, IV medications, oxygen therapy, laboratory testing, imaging, remote patient monitoring, and 24/7 access to medical professionals. Unlike traditional home health care, which provides intermittent services after a hospitalization, hospital at home programs are designed to replace the hospital stay itself for appropriate patients.
Who is hospital at home best suited for?
Hospital at home programs are generally designed for people who need hospital-level treatment but are medically stable enough to receive that care safely at home. Common conditions treated through HAH include pneumonia, heart failure, chronic obstructive pulmonary disease (COPD), cellulitis, and certain urinary tract infections.
Patients receiving hospital at home care typically need a safe home environment, reliable utilities, and medical conditions that do not require intensive care or immediate access to emergency procedures. A patient’s eligibility is ultimately determined by their treating hospital and their healthcare team.
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Research supports the benefits of HAH
Earlier this year, Congress extended Medicare’s Acute Hospital Care at Home waiver until September 30, 2030, allowing participating hospitals to continue providing these services while additional research evaluates their long-term effectiveness. One new study by researchers at the University of Iowa Carver College of Medicine quantified the benefits of the HAH approach to care.
A team of researchers evaluated nearly 16,000 Medicare beneficiaries hospitalized between 2021 and 2022, comparing patients treated through hospital at home programs with those receiving traditional inpatient care. The researchers found that, compared to a peer group of in-hospital patients, hospital at home patients had:
- Lower in-hospital mortality
- Fewer emergency department visits within 30 days after discharge
- Similar hospital readmission rates
- Slightly lower overall healthcare spending during the month following hospitalization
The findings suggest that for carefully selected patients, receiving acute care services at home can be just as safe, and in some cases even more beneficial than staying in a traditional hospital.
Potential benefits of hospital at home programs
For many older adults, remaining at home during treatment offers advantages beyond those benefits uncovered by the University of Iowa researchers.
According to the National Institute on Aging, in-patient hospitalization itself can increase an older adult’s risk of complications such as delirium, falls, infections, sleep disruption, and loss of mobility. Recovering in familiar surroundings, on the other hand, can help older patients sleep better, remain more active, spend more time with loved ones, and avoid exposure to hospital-acquired infections.
Hospital at home programs may also improve patient satisfaction while helping hospitals reserve inpatient beds for patients with more complex medical needs.
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There may be potential drawbacks to HAH as well
Although promising in many healthcare scenarios, hospital at home does have limitations. Certain medical conditions will likely always require traditional hospitalization, particularly when patients need intensive monitoring, surgery, or rapid access to specialists.
Some families may also find that having their loved one recover at home requires additional caregiver involvement, even with regular visits from healthcare professionals. Those family caregiving responsibilities can be stressful, mentally and physically, and may be logistically challenging for some families as well.
Other alternative care options
Hospital at home is just one route along a broader continuum of care for older adults. Depending on the patient’s unique health needs, other alternatives to traditional inpatient hospital care may include:
- Skilled nursing care facilities for short-term rehabilitation following a hospitalization
- Home health care for intermittent nursing needs or therapy services after discharge
- Assisted living communities for those who need help with activities of daily living but do not require hospital-level medical care
- Continuing care retirement communities (CCRCs, also called life plan communities), which offer independent living as well as multiple levels of care as health needs change
Understanding these options before a medical crisis occurs can make future healthcare decisions much less stressful.
>> Related: How to Talk to Aging Parents About Future Care Needs
Expanding care options for the future
Hospital at home represents an exciting evolution in healthcare delivery. Growing evidence suggests that medically qualified older adults can receive safe, high-quality hospital care at home while experiencing better quality of life, lower mortality, and fewer emergency department visits after discharge.
However, hospital at home isn’t a replacement for every hospitalization or senior living option. Instead, it expands the range of care choices available to older adults, giving patients and families greater flexibility when deciding where care can be delivered safely.
If you’re evaluating senior living and care options or planning for future healthcare needs, ask prospective retirement communities and healthcare providers how they might coordinate with local hospital at home programs, home health agencies, rehabilitation providers, and hospitals. Knowing your options today can help you make more informed care decisions tomorrow.
