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Evaluation of the Cincinnati Veterans Affairs Medical Center Hospital-in-Home Program

Shubing Cai1,2, Andrew Grubbs3, Rajesh Makineni2,4

  • 1Department of Public Health Sciences, University of Rochester, Rochester, New York.

Journal of the American Geriatrics Society
|April 21, 2018
PubMed

Insights

Hospital-in-Home (HIH) services for veterans significantly reduced healthcare costs and nursing home admissions compared to traditional inpatient care. Readmission rates and mortality showed no significant difference, highlighting HIH as a cost-effective alternative.

Area of Science:

  • Gerontology
  • Health Services Research
  • Veterans Affairs Healthcare

Background:

  • Hospital readmissions, costs, and mortality are significant concerns in healthcare.
  • The effectiveness and cost-efficiency of home-based care models require ongoing investigation.
  • Veterans often have complex health needs necessitating innovative care delivery.

Purpose of the Study:

  • To evaluate the impact of Hospital-in-Home (HIH) services on veterans' healthcare outcomes.
  • To compare the costs, readmission rates, mortality, and nursing home admissions between HIH and traditional inpatient care.
  • To assess the feasibility of HIH as an alternative to inpatient hospitalization for veterans.

Main Methods:

  • Retrospective cohort study at the Cincinnati Veterans Affairs Medical Center (VAMC).
  • Comparison of 138 veterans receiving HIH services versus 694 non-HIH veterans hospitalized for similar conditions.
  • Analysis of total costs, 30-day hospital readmissions, mortality, and nursing home admissions.

Main Results:

  • Average per-person costs were lower for HIH ($7,792) than inpatient care ($10,960).
  • HIH veterans had significantly lower 30-day nursing home admission rates (3.1% vs 12.6%).
  • No statistically significant differences in 30-day readmission rates or mortality were observed.

Conclusions:

  • The Hospital-in-Home model provides acute care at home for veterans at a lower cost and with reduced nursing home utilization.
  • HIH services demonstrate a viable, cost-effective alternative to traditional inpatient care for veterans.
  • Wider adoption of HIH could benefit older adults and reduce overall healthcare system expenditures.
Abstract

Keywords:
Hospital-in-Homeevaluationveterans

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