Researchers: Ella Kagan^1,2, Boris Punchick^1,2, Ilona Kolushev-Ivshin¹

Background: The Hospital at Home (HaH) model is an alternative to acute hospitalization in the hospital and is designed to provide medical care at the patient's home at the same level as he would receive in the hospital.

Objectives: To examine whether treatment under the HaH model compared to the pre-service entry period, is related to a decrease in healthcare services.

Method: A case-crossover study among Clalit Health Services members (in Beer Sheva and Ashkelon) who were treated in HaH between 01/01/2013-31/07/2020. Data were collected on the consumption of medical services and their cost during the 6 months prior to entering the service and during the service period.

Findings: The sample included 623 patients. The comparison between the treatment time in the unit and the six months prior showed a statistically significant decrease of 39% in the number of hospitalization days (2.84±4.35 vs. 1.70±3.80, p<0.001). In addition, there was a 33.5% decrease in hospitalization cost (3,889±7,952 vs. 5,855±7,914, p<0.001). The maximum benefit was observed in the group of patients who continued treatment in the unit until the end of the follow-up period, with a significant decrease (P<0.001) in the number of hospitalizations, the number of hospitalization days, and the cost of hospitalizations.

Conclusions: Treatment of homebound elderly patients with a high morbidity load and increased risk of hospitalization, provided in a home care unit by a multidisciplinary team, can significantly reduce the rate of re-hospitalizations, the number of hospitalization days, the number of emergency room referrals and the cost of hospitalizations.

Recommendations: Consideration should be given to admitting selected patients for long-term or permanent treatment in HaH units.

Research end date: 05/2024