A recent study led by Mass General Brigham and Ariadne Labs, in collaboration with rural health centers in the United States and Canada, has found that providing hospital-level care at home is a feasible option for patients in rural areas who have acute medical conditions. The research was published in JAMA Network Open.
The trial involved 161 adults who needed inpatient care for conditions such as infections, heart failure, chronic obstructive pulmonary disease, or asthma. Participants were recruited from Blessing Hospital in Illinois, Hazard Appalachian Regional Healthcare Regional Medical Center in Kentucky, and Wetaskiwin Hospital and Care Centre in Canada. They were randomly assigned to receive either traditional hospital care or home-based hospital care. The home-based model included twice-daily visits from nurses and paramedics and daily remote consultations with physicians or advanced practice providers.
To deliver this care at home, the study used technology designed to reduce the need for bulky medical equipment. Patients wore a wireless chest sticker for continuous monitoring instead of standard telemetry systems. Intravenous infusions were administered using portable pumps, and lab tests could be conducted at home with handheld meters.
Cost analysis showed no significant difference between the two groups overall. However, when patients were transferred to home care within three days of hospitalization, costs dropped by 27%. Readmission rates after 30 days were similar between both groups, and there were no major safety concerns identified.
Patients receiving care at home reported higher satisfaction levels compared to those treated in hospitals. On average, they took 700 more steps per day than their counterparts who remained hospitalized.
Researchers are continuing to examine how this model affects patient movement and caregiver experiences. They are also developing a mobile clinic equipped with necessary technology to bring hospital-level services to rural communities across the U.S.
"Hopefully this work can spur patients, clinicians, and healthcare leaders in rural areas to recommend, request, and build home hospital programs," Levine said. "Those particular areas that may have lost their hospital may be able to establish home hospital programs that are less expensive than brick-and-mortar care and employ clinicians that work locally. We hope others can use this research to take action in their communities because we have seen that when patients desire certain models of care, those models come to fruition. We feel this may be one innovation to help solve the rural healthcare crisis."
