Hospital at home works in rural areas: 6 notes

Hospital-at-home treatment could be one way to “solve the rural healthcare crisis,” researchers from Somerville, Mass.-based Mass General Brigham say.

Here are six findings from their Dec. 1 JAMA Network Open study, which randomly assigned 161 adult patients from Quincy, Ill.-based Blessing Hospital (IL), Hazard (Ky.) Appalachian Regional Healthcare Regional Medical Center and Wetaskiwin (Alberta, Canada) Hospital to either home hospital or traditional brick-and-mortar care:

1. Patient experience was dramatically higher for hospital at home, with a net promoter score nearly double the brick-and-mortar group.

2. Hospital-at-home patients were far more active, walking 714 more steps per day.

3. Because most rural patients weren’t transferred home until late in their hospital stay, overall costs looked similar between groups. But when patients went home earlier — within the first two days — the cost of care dropped by 27%, driven by fewer hospital days, fewer tests, and fewer specialist consults.

4. For hospital-at-home patients, their home care days were substantially more efficient, costing 50% less per day than their hospital days.

5. Safety outcomes were equivalent, with no significant differences in adverse events and similar readmission rates.

6. Enrollment refusals were 31%, compared to 63% refusal in prior urban trials.

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