Advanced technology permits the provision of advanced hospital care in the patients' homes.
Improvements in disease management and the aging of populations in Western countries are the main factors that have resulted in a disquieting rise in demand for expensive hospital beds. The patient-centred and family-friendly concept "Hospital at Home" has recently appeared on the global scene of health services, promising to offer a solution. This type of service has proved to be very welcome to patients and those they live with. However, Hospital at Home schemes reported in the literature are organized only to provide improved primary care services, usually to patients who are discharged from hospital a few days early and for the rest of their treatment. These services are mainly provided by nurses who perform one or fewer home visits a day and the medical contribution, if any, is limited to telephone consultations when necessary. Whenever something unusual happens the patient is readmitted. Some Hospital at Home settings, which are characterized as "admission avoidance", actually include only patients with conditions so stable that they might have stayed at home anyway, with some good primary care support. Yet Hospital at Home has much more to offer. Incorporated in the administrative structure of a hospital as real wards, manned with doctors, nurses and other health professionals on 24-hour duty in shifts and providing frequent--at least twice a day--regular home visits by doctors and nurses, Hospital at Home can reproduce real hospital conditions in the patients' homes. Portable medical devices enable the performance of a wide range of examinations at home, while information and communication technology neutralizes distances and makes collaboration between the virtual team and other contributors feasible and effective. Almost any patient whose condition neither requires prompt surgical operation nor meets the criteria for admission to an intensive care unit can be safely hospitalised at home, provided that he is attended by a properly organized, properly equipped and highly alert Hospital at Home service.
Papazissis
Elias
E
Hospital at Home Department, Hygeia Hospital, Greece.
D003195:Computer Communication Networks; D019468:Disease Management; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006801:Humans