Home, Sweet Hospital-At-Home? 

It depends, I hedge in my latest essay for Medecision.






In our bullish and, on its face, compassionate and cost-rational embrace of the migration of acute care from hospital beds to peoples’ living and bedrooms, there are several guardrails to consider beyond sheer payment and reimbursement calculations. Consider,

  1. The caregivers for the folks heading home from hospital
  2. The state of the physical home — for safety, comfort, environmental health, and emotional security, and,
  3. Food security and nutritional access.

On caregiving: I spend extra time detailing research in which Alexandra Drane, founder of ARCHANGELS, conducted in collaboration with the CDC on caregiver wellness. Caregivers’ stress grew more acute and intense during the COVID-19 pandemic, and by 2021 revealed that 70% of unpaid caregivers had at least one mental health condition such as anxiety, depression, or trauma and stress-related disorders.

On the state of the patient’s home: Dr. Sachin Jain and colleagues address obstacles to home-based care based on their experience with providing medical services to people at-home, recognizing that receiving care at home, “can be a constant reminder of illness and an unwelcome invasion of privacy” depending on the patient’s point of view and set of values.

On food security, the latest University of Michigan National Poll on Healthy Aging published in September found that rising food prices were hitting less-healthy older adults hardest.

In rounding out the article with positive opportunities to make hospital-at-home work, I call for greater collaboration between incumbent health care providers and community-based plus retail health organizations that bring care and services closer to people, based on their values and sense of value.

To get into these details and more, do read the piece in its entirety here at Medecision’s portal.