title: Hospital at home.
abstract: Although the acute hospital is the standard venue for treating acute serious illness, it is often a difficult environment for older adults who are highly susceptible to functional decline and other iatrogenic consequences of hospital care. Hospital care is also expensive. Providing acute hospital-level care at home, in lieu of usual institutional care, is viable. As an emerging service model, the definition of hospital at home (HaH) remains unsettled. Data favor HaH models that provide substantial physician inputs and are geared toward substituting for hospital care, provide service that is highly satisfying to patients and their caregivers, are associated with less iatrogenic complications, and are less expensive. Dissemination of HaH in integrated delivery systems is feasible. Widespread dissemination of HaH in the United States will require payment reform that acknowledges the role of HaH in the health care system.
authors.affiliation: Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cheng
authors.forename: Michael
authors.initials: M
authors.lastname: Montalto
authors.forename: Bruce
authors.initials: B
authors.lastname: Leff
mesh_terms: D000368:Aged; D006299:Health Services for the Aged; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration; D018718:Home Infusion Therapy; D006760:Hospitalization; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010819:Physician's Role