Hospital-at-Home in Taiwan: Reducing Hospital Stay and Medical Expenditures

Area of Science:

• Healthcare delivery models
• Comparative effectiveness research
• Health services research

Background:

• Hospital-at-Home (HaH) offers hospital-level care in a patient's residence, aiming to improve outcomes and cut costs.
• Global adoption of HaH contrasts with its recent pilot program initiation in Taiwan.
• This study compares HaH outcomes against traditional inpatient hospitalization within Taiwan.

Purpose of the Study:

• To evaluate the effectiveness of the Hospital-at-Home (HaH) model in Taiwan.
• To compare key outcomes between HaH patients and traditionally hospitalized patients.
• To assess the feasibility and impact of HaH on healthcare efficiency and resilience.

Main Methods:

• A retrospective cohort study was conducted at a Taiwanese tertiary medical center.
• Included HaH patients (n=69) with pneumonia, UTI, or soft tissue infections.
• Matched hospitalized cohort (n=246) based on age, sex, and diagnosis; analyzed length of stay, costs, ED visits, rehospitalization, and satisfaction.

Main Results:

• HaH patients experienced significantly shorter lengths of stay (aOR: 0.53) and lower medical expenditures (aOR: 0.18).
• A higher proportion of HaH patients transitioned to home healthcare (73.9% vs 7.3%), with 100% patient satisfaction.
• No significant differences were observed in emergency department visits or rehospitalization rates between cohorts.

Conclusions:

• Hospital-at-Home is a viable alternative to hospitalization, reducing length of stay and costs while ensuring patient safety and satisfaction.
• Expanding HaH services to more conditions can enhance overall healthcare efficiency.
• The study confirms HaH's feasibility in Taiwan and its potential contribution to healthcare system resilience.