Moving acute care into the home could save money, as patients outside of clinical settings may require less care hours from medical professionals to be treated effectively, according to a new study published in JAMA Network Open.
In-clinic acute care may involve time-consuming — and therefore expensive — activities that patients receiving care in the home may be able to bypass, the study found. Traveling to different hospital wards or consultations with medical professionals result in more personnel-hours of care that home-based settings can avoid. Meanwhile, home acute care patients can be trained to do many of the activities that clinicians perform, such as measuring vital signs or fluid intake, and consultations with medical professionals can be done virtually.
The researchers used Singapore hospital audit data from 2019 to 2021 to calculate the cost of time spent administering care by medical personnel. They found that one hospital patient required 1,085 minutes of care overall from medical personnel, on average. Home-based acute care patients only required 819 minutes. Nurses saved the most time, according to the study. In-clinic patients took up 776 minutes of nurses’ time, but home-based patients needed only 418 minutes.
This time saved becomes money saved; the researchers estimated that providers could save about $40,000 per patient by moving acute care into the home.
“A large proportion of the savings are attributed to a reduced burden on nursing and physician time, as well as eliminating unnecessary ‘bed and breakfast’ services in treating these conditions of low acuity and severity,” the study said.
While acute care in the home reduced time spent on these “bed and breakfast” activities, such as meals for patients, home hospitals did increase the amount of time spent on some aspects of care. Assessing patients’ homes for red flags and planning the logistics of delivering medication or laboratory results was also time-consuming, the study noted.
The temporary Medicare Acute Care Hospital at Home is set to expire next year; future legislative action would be required to extend it. Experts at the Medicare Payment Advisory Commission recently pointed out that data illustrating the value of home hospitals — both economically and in regards to patient outcomes — can help make the case for a more permanent Hospital at Home program.
