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History
 grew from the experiences of homebound older patients and their geriatricians. Many of these patients experienced adverse events when admitted to a hospital, while still others refused hospitalization because past hospital experiences were so difficult. Physicians found themselves forced to patch together a plan to deliver the best home-based care possible in a difficult set of circumstances.
To remedy this situation, Dr. John Burton, of the Johns Hopkins School of Medicine, and Dr. Donna Regenstreif of The John A Hartford Foundation conceived a new program to provide safe and effective hospital- level care in the home. A geriatric study team led by Dr. Bruce Leff developed medical eligibility criteria and the basic clinical model, while faculty from the Johns Hopkins University Bloomberg School of Public Health designed the study and measurement methodology.
A 17-patient pilot trial showed that Hospital at Home was feasible, safe and cost effective. Next, a National Demonstration and Evaluation Study was conducted to tested the feasibility of Hospital at Home in two Medicare managed care organizations and one Veterans Administration health center. The program was found to meet clinical process measures and quality standards at rates similar to the acute hospital. The average patient length of stay was shorter, which kept overall costs lower than an inpatient stay. Patients also had a lower chance of developing delirium, requiring sedatives, or needing chemical restraints. In addition, both patients and family members were more satisfied with care compared to those treated in the hospital.
Hospital at Home Today
Hospital at Home is in practice at numerous sites throughout the country, and is being adopted by innovators in health systems, home care organizations and managed care programs as a new tool to cost-effectively treat acutely ill older adults while improving patient safety and satisfaction.
Clinical and business experts of the Hospital at Home team are available to support your decision to adopt Hospital at Home at your institution. Our team provides consulting, along with a full set of tools to support planning, implementation and evaluation.
- Let us help you determine your site’s readiness to adopt Hospital at Home. Learn more.
- Contact Us for more information.
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