Virtual Home Care for Patients With Acute Illness

Area of Science:

• Health Services Research
• Digital Health
• Acute Care Medicine

Background:

• Evolving clinical care and remote monitoring technologies enable alternatives to intravenous therapy and inpatient hospitalization for acute illnesses.
• Traditional inpatient care for acute conditions can lead to prolonged hospital stays and increased healthcare system burden.

Purpose of the Study:

• To evaluate the outcomes of a novel outpatient, virtual, home-based acute care model named Safer@Home.
• To compare the effectiveness of Safer@Home with standard inpatient hospital care for acute illnesses.

Main Methods:

• A retrospective cohort analysis included 2466 patients treated for 34 acute illnesses between September 1, 2022, and August 31, 2023.
• The Safer@Home cohort (876 patients) received outpatient, home-based acute care with virtual monitoring and clinic visits.
• The control cohort (1590 patients) received standard, hospital-based care; outcomes included length of stay, mortality, and readmission rates.

Main Results:

• Safer@Home patients experienced significantly shorter mean inpatient stays (1.3 days) compared to the control cohort (5.3 days), avoiding 3505 bed-days.
• No significant differences were observed in all-cause mortality (2.6% vs 4.0%) or 30-day hospital readmissions (19.9% vs 16.7%) between the groups.
• While Safer@Home patients had more urgent care visits (37.3% vs 5.2%), total emergency department (ED) visits were not significantly different, and mean total ED visits per patient were lower in the Safer@Home group.

Conclusions:

• The Safer@Home model demonstrates a significant reduction in hospital length of stay for acute illnesses compared to standard inpatient care.
• This virtual, home-based acute care model shows promise, with no significant increase in mortality, ED revisits, or return hospitalizations.
• Safer@Home offers a viable alternative for healthcare systems, particularly those facing challenges in staffing hospital-at-home services.