Hospital-at-home Boosts Patient Experience Without Raising Costs For Rural Patients

New research shows that hospital-level care is possible for adults living in rural settings – and that people receiving acute care in the home are more physically active than those in brick-and-mortar hospital care.

Rural patients also strongly prefer receiving acute care at home, according to a study published in JAMA Network Open, though the study did not find that acute care at home reduced costs or readmissions compared with traditional hospital care.

“(Rural home hospital) [RHH] had no difference in cost or health care utilization, while significantly improving patient experience and physical activity,” the study’s authors wrote. “It is important to place these results in context for patients and policymakers: to our knowledge, there are few interventions that improve patient experience and physical activity without requiring a higher cost.”

The study utilized data from a randomized clinical trial involving 161 adults who visited the emergency department and required hospital-level care for select acute conditions. The trial was held from 2022 to 2023 in three rural areas in the U.S. and Canada.

Patients were split into the home hospital group and a control, brick-and-mortar hospital group. Patients in the home hospital group were less sedentary. According to accelerometer measurements, these patients were sedentary 78% of the day compared to 86% of the day for the control group. They also took more steps each day: home-based patients averaged 834.1 steps per day, and the control group averaged 120.4 steps per day.

Patient experience also improved, with home hospital patients averaging a net-promoter score of 88.4 and the control group averaging a score of 45.5.

While the study did not find improvements in cost or 30-day readmission rates among patients receiving hospital-at-home services, an analysis by the researchers suggested that, if patients had transferred home sooner, there likely would have been cost and utilization improvements.

In addition to finding that rural hospital-at-home is feasible, the study found that rural patients were more likely to accept these services in their homes than urban patients. Previous studies found that urban patients declined to enroll in hospital-at-home services 63% of the time, but that figure dropped to 31% for rural patients.

Increased adoption of hospital-at-home models has been hampered by the lack of long-term extension of the Acute Hospital Care at Home program – and one notable operator in the space, Inbound Health, recently shuttered, citing regulatory uncertainty. 

A bipartisan bill aiming to provide a longer-term extension passed through the U.S. House of Representatives this week. The bill would extend the hospital-at-home waiver through 2030. 

The post Hospital-at-Home Boosts Patient Experience Without Raising Costs For Rural Patients appeared first on Home Health Care News.