A Multidisciplinary Hospital-at-Home Program in a Tertiary Singapore Hospital: A Comparative Study.
Natalie Yingxian Ong1, Shirley Xin Jin Chu2, Milawaty Nurjono2
1Department of Acute and Rehabilitative Care at Home (ARCH), Changi General Hospital, Singapore, Singapore. natalie.ong.yingxian@singhealth.com.sg.
Journal of General Internal Medicine
|November 1, 2025
Summary
Hospital-at-home (HaH) care in Singapore reduced hospital stays without increasing mortality or costs. While readmissions were similar, HaH patients had more emergency department visits post-discharge, suggesting a need for improved follow-up.
Area of Science:
- Healthcare delivery models
- Acute care innovation
- Comparative effectiveness research
Background:
- Hospital-at-home (HaH) provides acute care in patients' residences, a model established in Western countries.
- Asian healthcare systems face unique challenges, necessitating evaluation of HaH's impact in this region.
Purpose of the Study:
- To compare the effectiveness and safety of Hospital-at-home (HaH) care versus conventional inpatient care.
- To assess outcomes including length of stay, mortality, cost, and post-discharge utilization in an Asian tertiary hospital setting.
Main Methods:
- Retrospective analysis comparing 143 HaH patients with 147 control patients receiving usual inpatient care.
- Outcomes measured: in-hospital and total length of stay (LOS), mortality, costs, 30- and 90-day readmissions, and emergency department (ED) visits.
Main Results:
- HaH patients experienced significantly shorter in-hospital LOS (-40%, 5 days) but longer total LOS (+28%, 2 days).
- No significant differences in mortality, 30- or 90-day readmissions, or 30-day ED visits were observed.
- HaH patients showed a higher likelihood of post-discharge ED utilization within 90 days; costs were comparable.
Conclusions:
- Hospital-at-home care in an Asian tertiary hospital setting is feasible, demonstrating shorter in-hospital LOS with comparable mortality and costs.
- Findings support HaH adoption in similar Asian healthcare contexts, highlighting the need for robust post-discharge support to manage ED utilization.
- Evidence guides policymakers on integrating home-based acute care models effectively.
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