COVID-19 Stalls Hospital in the Home Revolution

In November last year, federal health minister Greg Hunt called for a ‘hospital-in-the-home’ revolution. He told state and territory governments and private health insurers he wanted more care delivered in patients’ homes rather than hospitals, and pledged to make it easier for these services to qualify for funding. Hunt’s outlined plan for a major shake-up of rules governing private health insurance in a bid to arrest an exodus of customers as premiums rise has inevitably been stalled by the COVID-19 pandemic, but it’s not all bad news.

The current state of hospital in the home

Hospital in the home is already a widespread practice in Australia. Nationwide, more than 595,000 days of hospital in the home care were delivered in 2017-18 for public patients, accounting for more than 5% of acute-care bed days.

Yet in the private sector, fewer than 1% of acute bed days were delivered at home.

“Hospital in the home” is just what it sounds like – an acute care service that provides care in the home that would otherwise need to be received as an inpatient. It provides an alternative to hospital admission, or an opportunity for earlier discharge than would otherwise be possible. Research has found it is also associated with a lower likelihood of readmission within 28 days (2.3% vs 3.6%) and lower rates of patient deaths (0.3% vs 1.4%), compared with being an inpatient.

For patients, the benefits include increased comfort, less noise, freedom of movement, more palatable food and, crucially, reduced exposure to hospital-acquired infections. Treating patients in their homes can also improve responsiveness to cultural and socioeconomic needs, and provide support for carers. Plus, patients and carers alike appreciate the ability to choose an alternative to hospital admission and feel more in control when care is delivered in their own home.

Hospital in the home and COVID-19

While the promised revolution has been stalled by COVID-19, the pandemic also provides a timely reminder of the importance and potential of Hospital in the Home. According to the Health Times, COVID-19 might paradoxically provide even greater impetus for this type of care model.

In the short term, home treatment can relieve pressure on the acute hospital system. One example is the Victorian government’s support for mental health care delivered to young people via hospital in the home during the pandemic.

Longer term, the rapid boost to telehealth and remote monitoring technology driven by COVID-19 will greatly benefit hospital in the home.

Patients’ and carers’ perceptions of home hospital care are also likely to have improved as a byproduct of COVID-19, as people avoid visiting hospitals in person if possible. These attitudes may last well beyond the pandemic.

If nothing else, COVID-19 has informed us that change can happen fast when it’s really needed.

This article has been adapted from and article published on The Conversation under a Creative Commons license. Read the original article.