A study of more than 5,000 adults found that acute hospital care at home (AHCaH) may provide important benefits to a diverse group of medically complex and socially vulnerable patients. Hospital care at home also was associated with low mortality, escalation, and re-admission rates. However, the current AHCaH waiver issued by the Centers for Medicare & Medicaid Services (CMS) in the US is set to expire in December 2024. The report is published in Annals of Internal Medicine.
Hospitalisation is the standard of care for acute illness, but hospital care is often expensive, unsafe, and uncomfortable. Prior research has shown that compared with traditional inpatient hospital care, patients cared for in AHCaH have improved experiences and physical activity levels, with lower rates of mortality, re-admission, and discharge to skilled-nursing facilities. In November 2020, the Centers for Medicare & Medicaid Services issued the AHCaH waiver, creating a regulatory and payment pathway for hospitals to deliver AHCaH. However, this waiver is set to expire in December 2024.
Researchers from Brigham and Women’s Hospital and Harvard Medical School analysed data for 5,132 patients receiving AHCaH between July 2022 and June 2023. Of the patients studied, 42.5% had heart failure, 43.3% had chronic obstructive pulmonary disease, 22.1% had cancer, and 16.1% had dementia.
AHCaH was associated with low rates of mortality, escalation, skilled nursing facility use, and re-admission. According to the authors, their data provide preliminary evidence on national uptake and suggest that AHCaH is an important care model to manage acute illness, including among socially vulnerable and medically complex patients. They suggest that these data should help inform ongoing policy deliberations.