Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities

Abstract The $1 trillion industry of acute hospital care in the United States is shifting from inside the walls of the hospital to patient homes. To tackle the limitations of current hospital care in the United States, on November 25, 2020, the Center for Medicare & Medicaid Services announced t...

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Main Authors: Kei Ouchi, Shan Liu, Daniel Tonellato, Yonatan G. Keschner, Maura Kennedy, David M. Levine
Format: Article
Language:English
Published: Elsevier 2021-08-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12517
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author Kei Ouchi
Shan Liu
Daniel Tonellato
Yonatan G. Keschner
Maura Kennedy
David M. Levine
author_facet Kei Ouchi
Shan Liu
Daniel Tonellato
Yonatan G. Keschner
Maura Kennedy
David M. Levine
author_sort Kei Ouchi
collection DOAJ
description Abstract The $1 trillion industry of acute hospital care in the United States is shifting from inside the walls of the hospital to patient homes. To tackle the limitations of current hospital care in the United States, on November 25, 2020, the Center for Medicare & Medicaid Services announced that the acute hospital care at home waiver would reimburse for “home hospital” services. A “home hospital” is the home‐based provision of acute services usually associated with the traditional inpatient hospital setting. Prior work suggests that home hospital care can reduce costs, maintain quality and safety, and improve patient experiences for select acutely ill adults who require hospital‐level care. However, most emergency physicians are unfamiliar with the evidence of benefits demonstrated by home hospital services, especially for older adults. Therefore, the lead author solicited narrative inputs on this topic from selected experts in emergency medicine and home hospital services with clinical experience, publications, and funding on home hospital care. Then we sought to identify information most relevant to the practice of emergency medicine. We outline the proven and potential benefits of home hospital services specific to older adults compared to traditional acute care hospitalization with a focus on the emergency department.
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issn 2688-1152
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publishDate 2021-08-01
publisher Elsevier
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series Journal of the American College of Emergency Physicians Open
spelling doaj-art-66fb52bf7f7b4d3a8e00e6bf4470abd92025-08-20T03:34:48ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-08-0124n/an/a10.1002/emp2.12517Home hospital as a disposition for older adults from the emergency department: Benefits and opportunitiesKei Ouchi0Shan Liu1Daniel Tonellato2Yonatan G. Keschner3Maura Kennedy4David M. Levine5Department of Emergency Medicine Brigham and Women's Hospital Boston Massachusetts USAHarvard Medical School Boston Massachusetts USADepartment of Emergency Medicine MedStar Georgetown University Hospital Washington District of Columbia USADepartment of Emergency Medicine Brigham and Women's Hospital Boston Massachusetts USAHarvard Medical School Boston Massachusetts USAHarvard Medical School Boston Massachusetts USAAbstract The $1 trillion industry of acute hospital care in the United States is shifting from inside the walls of the hospital to patient homes. To tackle the limitations of current hospital care in the United States, on November 25, 2020, the Center for Medicare & Medicaid Services announced that the acute hospital care at home waiver would reimburse for “home hospital” services. A “home hospital” is the home‐based provision of acute services usually associated with the traditional inpatient hospital setting. Prior work suggests that home hospital care can reduce costs, maintain quality and safety, and improve patient experiences for select acutely ill adults who require hospital‐level care. However, most emergency physicians are unfamiliar with the evidence of benefits demonstrated by home hospital services, especially for older adults. Therefore, the lead author solicited narrative inputs on this topic from selected experts in emergency medicine and home hospital services with clinical experience, publications, and funding on home hospital care. Then we sought to identify information most relevant to the practice of emergency medicine. We outline the proven and potential benefits of home hospital services specific to older adults compared to traditional acute care hospitalization with a focus on the emergency department.https://doi.org/10.1002/emp2.12517dispositionGeriatricshealthcare deliveryhome hospitalpalliative carepatient‐centered care
spellingShingle Kei Ouchi
Shan Liu
Daniel Tonellato
Yonatan G. Keschner
Maura Kennedy
David M. Levine
Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities
Journal of the American College of Emergency Physicians Open
disposition
Geriatrics
healthcare delivery
home hospital
palliative care
patient‐centered care
title Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities
title_full Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities
title_fullStr Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities
title_full_unstemmed Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities
title_short Home hospital as a disposition for older adults from the emergency department: Benefits and opportunities
title_sort home hospital as a disposition for older adults from the emergency department benefits and opportunities
topic disposition
Geriatrics
healthcare delivery
home hospital
palliative care
patient‐centered care
url https://doi.org/10.1002/emp2.12517
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AT shanliu homehospitalasadispositionforolderadultsfromtheemergencydepartmentbenefitsandopportunities
AT danieltonellato homehospitalasadispositionforolderadultsfromtheemergencydepartmentbenefitsandopportunities
AT yonatangkeschner homehospitalasadispositionforolderadultsfromtheemergencydepartmentbenefitsandopportunities
AT maurakennedy homehospitalasadispositionforolderadultsfromtheemergencydepartmentbenefitsandopportunities
AT davidmlevine homehospitalasadispositionforolderadultsfromtheemergencydepartmentbenefitsandopportunities