Harvard pilot of home hospital found to cut acute care episode costs in half

The Harvard Medical School study included adults with any infection or exacerbation of heart failure, chronic obstructive pulmonary disease or asthma who were admitted via the emergency department. The patients also had to live in the hospital's surrounding area. A group of patients received their care at home, while others in a received the usual care in the hospital. Patients who were cared for at home received daily visits from an internist and two daily visits from a nurse. The home hospital model also included 24-hour physician coverage and electronic connectivity, including continuous monitoring, video and texting. Some key results were as follows:

• The median direct cost of the acute care episode for home patients was 52% lower than for control patients;
• Home patients had fewer laboratory orders and less often received consultations;
• Home patients were more physically active, with a trend toward more sleep;
• No adverse events occurred among the home patients, one occurred among the control patients; and
• The median direct cost for the acute care plus 30-day post-discharge period for home patients was 67% lower, with trends toward less use of home care services and fewer re-admissions.