Lessons From Abroad On Hospital-At-Home Efficacy And Adoption

U.S.-based hospital-at-home advocates regularly point abroad to make the case for the model’s adoption domestically.

In other developed countries, hospital-at-home models tend to be far more common than they are in the U.S.

With this in mind, providers and policymakers may need to look further at those counterparts across the globe to expand hospital at home adoption.


Michael Montalto, the director of hospital in the home at Epworth Hospital – which operates in Australia – believes that cultural change needs to take shape, even ahead of policy advancements.

“Policymakers can change their minds, funders can change their minds, but if you start to become encultured into the hospital, then that really has a very sticky kind of personality to it,” he said during a panel discussion at the Virtual Advanced Healthcare at Home Summit on Tuesday.

Even though many of the early hospital-at-home models were developed and tested in the U.K., Dr. Dan Lasserson — the physician lead of the acute hospital-at-home service at Oxford University Hospitals — describes the reactions the care delivery model receives as “hot and cold.”


“We do what we can to show people that just because you’re at home doesn’t mean you don’t get the great things a hospital can do,” he said during the discussion.

For Sabar Health, a hospital at home provider in Israel, investing in PR has been an important strategy.

“We are a private company and we wanted to push the market forward,” Sabar Health CEO Dr. Itamar Offer said. “PR works very [well], as does testimonials of families who are actually sharing their experience at home, and the huge difference from being in a hospital.”

At Sabar Health, 90% of patients that have been given the option to be cared for in their homes have said yes, according to Offer.

Ultimately, the goal of hospital at home should be to take the good practices that happen in the hospital and move those practices into the home, according to Dr. Bruce Leff, the professor of medicine and director of the Center for transformative geriatric research at Johns Hopkins University School of Medicine.

Leff is one of the pioneers of the hospital-at-home model in the U.S.

“It may look the same, and it may look adapted and different in the home to maximize patient outcomes,” he said. “At least in the U.S., studies over the last 30 years replicated again in the past year [found that] one in four patients treated in our acute care hospitals experienced major adverse outcomes. We want to try and take what’s good, leave behind what’s bad, and have a better experience for patients and their families.”

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