Amid the Covid-19 pandemic and a growing interest in at-home care, DispatchHealth has published new data showing that its hospital-at-home program did not result in unexpected deaths, serious adverse events or patients being subsequently admitted to a skilled nursing facility.
Evidence of the safety and efficacy of hospital-at-home programs continues to mount as such programs are becoming more prevalent throughout the United States. With the recent spike in COVID-19 cases in New Jersey and Pennsylvania, many are turning toward home health care options as an alternative to inpatient care. Contact Sena Health today to find out more about receiving patient-centric, hospital-level care in the comfort of your home.
By Anuja Vaidya
DisptachHealth, an in-home care company, released new data showing the efficacy of its hospital-at-home program launched last year. None of the patients treated as part of the program died unexpectedly or experienced serious safety events, adding evidence to support the use of these programs as interest in them grows amid the Covid-19 pandemic.
The popularity of hospital-at-home programs — where hospital-level care is brought to a patient’s bedside in their own home — has grown steadily. Many major health systems, including Johns Hopkins Medicine and Mount Sinai Health System, have implemented these programs as research shows them to be safe and effective at reducing death rates, readmissions and costs.
Since the Covid-19 pandemic hit, the interest in hospital-at-home programs has spiked even further. Many patients, especially those who are older with multiple underlying conditions, have found themselves in the difficult position of needing hospital-level care but also being especially vulnerable to Covid-19. Increasingly, health systems are looking to the hospital-at-home model to care for this population, either by setting up their own versions of the model or partnering with companies that offer the program.
“I used to get maybe 10 calls a month. Now I get 20 or 30. The field has just exploded,” Dr. Bruce Leff, who runs a program at Johns Hopkins that advises organizations wanting to develop hospital-at-home programs, told the Association of American Medical Colleges.
The pandemic has also driven demand for DispatchHealth’s hospital-at-home program, launched in December 2019, Dr. Mark Prather, co-founder and CEO of the company, said in a phone call. It offers direct-to-consumer at-home care services as well as partners with health systems and payers. Its hospital-at-home program offers acute care patients comprehensive medical services in their home as an alternative to being admitted to a hospital.
“[Our emergency care team] shows up [at the patient’s house], diagnoses the patient, determines appropriateness and then admits them to the program, all in one fell swoop,” said Prather.
In addition, the program provides up to 30 days of in-home clinical support for the patients.
But the company wanted to participate in the academic discussions about outcomes surrounding this model, said Prather. So, DispatchHealth decided to study outcomes for the first 38 patients who received care via the hospital-at-home program, and they published the results as a poster in the Journal of Hospital Medicine. They tracked the patients for 30 days and examined several outcomes measures. The patients needed treatment for an array of conditions, including pneumonia and chronic obstructive pulmonary disease.
They found that the serious safety event rate and unexpected mortality rate was 0%. The 30-day readmission rate — which in this case refers to a subsequent hospitalization — was 3%. The emergency department escalation rate, which refers to the proportion of patients in the program who had to go to an ED, was 7%. None of the patients required admission to a skilled nursing facility.
In 25% of the cases, DispatchHealth care team members adjusted care goals and many of these were end-of-life discussions, Prather said.
“Just having 30 days to develop a relationship with a patient allows you to have different goals of care discussions,” he said. “It allows you to look at the social issues in the home and address those in a different manner. So we published an outcome related to that and it’s something we track on every admission.”
In addition, for about 65% of patients in the program, the company’s care team worked with the patients’ other physicians and caregivers to go over the medications they were currently on and make necessary adjustments.
“[Hospital-at-home programs] are much more commonplace in other countries,” he said. “The medical literature suggests that this is the right thing to do, we just haven’t really caught up as a country.”
DispatchHealth operates in 25 markets, and it plans to expand to 28 by the end of the year.