What if you needed intensive care for a chronic medical problem but instead of being admitted to a hospital, you could stay right in your own bedroom? That appealing scenario is not a far-fetched dream but a reality, at least in several areas of the country including Albuquerque, Honolulu, Boise, New Orleans, and Portland. According to a study published in the June issue of Health Affairs, patients in "Hospital at Home" programs had similar and in some cases even better outcomes than a control group who were in the hospital.
The researchers, led by Lesley Cryer, RN, executive director of the Home Healthcare Division of Presbyterian Healthcare Services in Albuquerque, also reported that the home care patients had a lower rates of falls and that fewer of them died during the study period. Examples of diseases and conditions that treated at home are congestive heart failure, COPD, community-acquired pneumonia, cellulitis, deep venous thrombosis, pulmonary embolism, complicated urinary tract infection or urosepsis, nausea and vomiting, and dehydration.
Patients in Albuquerque, all of whom must live within 25 miles of an emergency department, receive prescriptions as well as counseling about signs of disease recurrence. They also get follow-up appointments with doctors. Participating physicians in the New Mexico pilot study usually visit five patients a day and they are available 24/7 for emergencies. Nurses visit each patient once or twice a day and "tele-health" units are set up in the homes with a blood pressure monitor, stethoscope, oximeter (a hemoglobin monitor for COPD patients), glucometer (a blood sugar monitor for diabetics), and a connection that makes video chats possible.
