Hospital-Level Care at Home for Acutely Ill Patients

Hospital-Level Care at Home, often referred to as Hospital-at-Home (HaH), is an innovative model that delivers acute medical and nursing interventions in the patient’s domestic environment. Originally developed to alleviate bed shortages and reduce healthcare expenditure, HaH replicates inpatient protocols—such as intravenous therapy, advanced monitoring and multidisciplinary rounds—within the home setting. Utilising a combination of in-person visits and telehealth platforms, the model mitigates risks associated with hospitalisation, including nosocomial infections, delirium and functional decline. Technological advancements in wearable sensors, remote patient monitoring and integrated health-information systems have underpinned the rapid expansion of HaH services, particularly during pandemic surges. Clinical outcomes across diverse diagnoses—ranging from infectious pneumonia and heart failure to post-operative care—demonstrate comparable or improved recovery trajectories, shorter acute-phase lengths of stay and enhanced patient satisfaction. Economically, HaH models have shown reductions in direct hospital costs, lower readmission rates and preservation of fixed resources. Yet the widespread adoption of HaH continues to face challenges related to regulatory frameworks, reimbursement structures, workforce training and the integration of digital health infrastructure. As healthcare systems globally confront ageing populations and capacity constraints, Hospital-Level Care at Home represents a patient-centred strategy with profound implications for delivering safe, effective and scalable acute care beyond institutional walls.

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Hospital-Level Care at Home for Acutely Ill Patients publication trend

The graph below shows the total number of articles in hospital-level care at home for acutely ill patients across all publications each year (not limited to Nature Index journals).

Technical terms

Hospital-at-Home (HaH): A care model delivering hospital-level medical and nursing services in a patient’s home rather than in a traditional inpatient setting.

Remote Patient Monitoring (RPM): The use of digital technologies—such as wearable sensors and telehealth platforms—to collect and transmit patient health data for clinical evaluation.

Acute Care: Short-term, intensive medical attention provided to patients with urgent or severe health conditions requiring rapid intervention.

Command Centre: A centralised unit utilising virtual platforms and in-person teams to coordinate and oversee multiple HaH patient care pathways in real time.

References

1. The hospital at home in the USA: current status and future prospects. npj Digital Medicine (2024).
2. The Next Frontier of Remote Patient Monitoring: Hospital at Home. Journal of Medical Internet Research (2023).
3. Implementation of a virtual and in-person hybrid hospital-at-home model in two geographically separate regions utilizing a single command center: a descriptive cohort study. BMC Health Services Research (2023).