Is Home-Based Care the Hospital of the Future?

​Providing hospital-level care at a patient's home plus 30 days of postacute care as an alternative to hospitalization after an emergency department (ED) visit has the potential to improve patient outcomes, according to a study published in the August 2018 JAMA Internal Medicine. The study was funded as a demonstration project for the Medicare program, which does not currently pay for the so-called "hospital-at-home" benefit. The study enrolled 507 patients (mean age 74.6 years) treated at two New York City hospital EDs and eligible for hospital admission. Of the 507 patients who met eligibility for the hospital-at-home model, 295 agreed to participate in the program; the remaining 212 control patients who were eligible either refused participation or were treated in the ED at times when the clinicians who could initiate hospital-at-home coverage were unavailable. Some of the most frequently treated diagnoses that qualified patients for the program were urinary tract infections, community-acquired pneumonia, cellulitis, and congestive heart failure.