Hospitalizations at Home in Israel, a Retrospective Observational Study

Area of Science:

• Health Services Research
• Public Health Policy
• Geriatric Care

Background:

• Israel faces rising hospitalizations due to an aging population and demographic growth.
• The Ministry of Health is expanding community-based care, including Hospital at Home (HaH) services.

Purpose of the Study:

• To evaluate the impact of a 2019 financial incentive policy on the volume and geographic distribution of HaH services in Israel.
• To analyze trends in HaH admissions before and after the policy implementation.

Main Methods:

• Retrospective analysis of Ministry of Health data on HaH admissions from 2017-2023 (excluding COVID-19).
• Data included admission volume, length of stay, referral source, patient demographics, and geographic residence.
• Analysis focused on changes following the introduction of financial incentives for Health Maintenance Organizations (HMOs).

Main Results:

• HaH admissions surged from 8 in 2017 to 33,141 in 2023, with rapid growth post-policy implementation.
• Mean monthly HaH days increased substantially, reaching 2762 in 2023.
• A growing proportion of HaH admissions originated from central Israel, with a relative decline in peripheral areas. Readmission rates were low.

Conclusions:

• Hospital at Home (HaH) is a viable model to address Israel's increasing inpatient care demand.
• Policy interventions are needed to overcome expansion barriers, particularly in peripheral regions, to ensure equitable geographic access to HaH services.