Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb 27;7(1):48.
doi: 10.1038/s41746-024-01040-9.

The hospital at home in the USA: current status and future prospects

Jay A Pandit  1 , Jeff B Pawelek  2 , Bruce Leff  3 , Eric J Topol  2
Affiliations
Review

The hospital at home in the USA: current status and future prospects

Jay A Pandit et al. NPJ Digit Med. .

Abstract

The annual cost of hospital care services in the US has risen to over $1 trillion despite relatively worse health outcomes compared to similar nations. These trends accentuate a growing need for innovative care delivery models that reduce costs and improve outcomes. HaH-a program that provides patients acute-level hospital care at home-has made significant progress over the past two decades. Technological advancements in remote patient monitoring, wearable sensors, health information technology infrastructure, and multimodal health data processing have contributed to its rise across hospitals. More recently, the COVID-19 pandemic brought HaH into the mainstream, especially in the US, with reimbursement waivers that made the model financially acceptable for hospitals and payors. However, HaH continues to face serious challenges to gain widespread adoption. In this review, we evaluate the peer-reviewed evidence and discuss the promises, challenges, and what it would take to tap into the future potential of HaH.

PubMed Disclaimer

Conflict of interest statement

J.A.P. has a paid consulting relationship with QuidelOrtho, receives payment or honoraria from Niterra, serves on an advisory board for Cardiosense, Preciseli, Bodyport, Angiotensin Tx, and Lytic, and has stock options through advisory positions with Cardiosense, Preciseli, Bodyport, and Angiotensin Tx. B.L. has paid consulting relationships with Medically Home, Chartis, and Kenes and has stock options with Medically Home and Dispatch Health. J.B.P and E.J.T. declare no competing interests.

Figures

Fig. 1
Fig. 1. Analog to digital evolution of hospital at home.
From left to right, the expansion of assets and advancements in technologies continue to evolve for acute care hospital at home. Physician extenders include providers such as nurse practitioners and physician assistants. Intervention team includes several types of medical professionals such as paramedics, physical therapists, and phlebotomists.
Fig. 2
Fig. 2. The Future of Hospital at Home.
The data life cycle for a future Hospital at Home model with practical and technological barriers for broad implementation. Multimodal patient data is aggregated, analyzed, integrated, interpreted, and applied to provide acute-level care in the home.
See this image and copyright information in PMC

References

    1. Starr P. (eds) The Social Transformation of American Medicine (Basic Books, 2017).
    1. Rosenberg C. E. (eds) The Care of Strangers : The Rise of America’s Hospital System (Johns Hopkins University Press, 1995).
    1. Sorenson C, Drummond M, Bhuiyan Khan B. Medical technology as a key driver of rising health expenditure: disentangling the relationship. Clinicoecon. Outcomes Res. 2013;5:223–234. - PMC - PubMed
    1. Kisacky J. An architectural history of US community hospitals. AMA. J. Ethics. 2019;21:E288–E296. - PubMed
    1. Brennan TA, et al. Incidence of adverse events and negligence in hospitalized patients - results of the harvard medical practice study I. N. Engl. J. Med. 1991;324:370–376. - PubMed