ArticleIsrael journal of health policy research2024
The outcomes of treatment for homebound adults with complex medical conditions in a hospital-at-home unit in the southern district of Israel.
Article in Israel journal of health policy research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 6 citations in OpenAlex.
- Unexpected consequences of community-based integrated care services reform: increased hospitalization expenses among older adults in China, 2011-2018.Frontiers in public health · 2026Article
- Lessons from a large national "hospital at home" program.Israel journal of health policy research · 2025Article
- Mapping the landscape of Hospital at home (HaH) care: a validated taxonomy for HaH care model classification.BMC health services research · 2025Article
- Perceptions of home hospitalization among the public and physicians in Israel: findings from surveys conducted for the Dead Sea Health Policy Conference of 2022.Israel journal of health policy research · 2024Article
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10 authors at 3 institutions in 1 country.
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Abstract
backgroundA model of hospital-at-home services called the Home Care Unit ("the unit") has been implemented in the southern region of the Clalit Healthcare Services in Israel. The aim of the present study was to characterize this service model.
methodsA retrospective cross-over study. included homebound patients 65 years of age and above who were treated for at least one month in the framework of the unit, between 2013 and 2020. We compared the hospitalization rate, the number of hospital days, the number of emergency room visits, and the cost of hospitalization for the six-month period prior to admission to the unit, the period of treatment in the unit, and the six-month period following discharge from the unit.
resultsThe study included 623 patients with a mean age of 83.7 ± 9.2 years with a mean Mini-mental State Examination (MMSE) score of 12.0 ± 10.2, a mean Charlson Comorbidity Index (CCI) of 3.7 ± 2.2 and a Barthel Index score of 23.9 ± 25.1. The main indications for admission to the unit were various geriatric syndromes (56.7%), acute functional decline (21.2%), and heart failure (12%). 22.8% died during the treatment period and 63.4% were discharged to ongoing treatment by their family doctor after their condition stabilized. Compared to the six months prior to admission to the unit there was a significant decrease (per patient per month) in the treatment period in the number of days of hospitalization (2.84 ± 4.35 vs. 1.7 ± 3.8 days, p < 0.001) and in the cost of hospitalization (1606 ± 2170 vs. 1066 ± 2082 USD, p < 0.001).
conclusionsTreatment of homebound adults with a high disease burden in the setting of a hospital-at-home unit can significantly reduce the number of hospital days and the cost of hospitalization. This model of service for homebound patients with multiple medical problems maintained a high level of care while reducing costs. The results support the widespread adoption of this service in the community to enable the healthcare system to respond to the growing population of elderly patients with medical complexity.
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