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Despite its numerous advantages and benefits, developing and executing a Hospital at Home (HaH) service that offers a true alternative to a standard hospital admission remains elusive in Canada.
Running a HaH program isn’t cheap: staff to patient ratios can be double the ones of the hospital; staff transportation and remote monitoring technologies also add to the operating costs. These operating costs are certainly justified when HaH functions as an acute care service, offering an alternative to a standard hospital admission. Unfortunately HaH programs have a tendency to intervene well past the acute phase and become little more than a glorified, albeit very expensive, discharge to home program. An example of this is the HaH program in Victoria BC, where patients are identified and taken charge while already hospitalized, past their acute phase, allowing them to complete their therapies at home while supervised. Despite the benefits of returning patients home a few days early, this type of program is unlikely to be cost-effective or even qualify as a true HaH program, for three reasons. First, despite the high operating costs of what should be an acute care service it operates as a post-acute one. Second, the Canadian healthcare system already has many post-acute care programs and services, some of which have been operating for decades, such as the home IV program. Any other post-acute program risks duplicating them, even if they bear the name of HaH. Third, by not...
Show MoreCompeting Interests: None declared.References
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- 3. Shepperd S, Iliffe S, Doll HA, et al. Admission avoidance hospital at home. Cochrane Database Syst Rev. 2016;9:CD007491.