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Published on: April 19, 2019
Advanced Medical Care at Home Among Patients With Acute Heart Failure
Cheng-Wei Huang1,2, Dan N Huynh3, Bing Han4
1Department of Hospital Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
JAMA Network Open
|July 16, 2026
Summary
Advanced medical care at home (AMCAH) demonstrated comparable safety and quality to traditional brick-and-mortar (BAM) hospitalizations for heart failure (HF). This study found no significant differences in readmissions, mortality, or other key outcomes at 30 or 60 days.
Area of Science:
- Cardiology and Health Services Research
- Comparative effectiveness of healthcare delivery models
Background:
- Limited contemporary data exist on the safety and quality of acute hospital care at home for heart failure (HF).
- Evaluating alternative care models is crucial for optimizing patient outcomes and resource allocation.
Purpose of the Study:
- To compare the safety and quality outcomes of an advanced medical care at home (AMCAH) program versus traditional brick-and-mortar (BAM) hospitalization for patients with HF.
- To assess the feasibility and effectiveness of delivering acute HF care in a home setting.
Main Methods:
- Retrospective cohort study involving adult patients hospitalized with HF across 11 service areas.
- Propensity score matching was employed for intra- and inter-service area comparisons.
- Outcomes included a composite of all-cause escalation, readmission, or mortality at 30 and 60 days, days alive and out of hospital (DAOH), and guideline-directed medical therapy (GDMT) scores.
Main Results:
- No significant differences were observed in the 30-day composite outcome (AMCAH vs. BAM: 24% vs. 26% intra-service; 22% vs. 25% inter-service).
- Secondary outcomes, including escalation, readmission, mortality, DAOH, and GDMT scores, also showed no significant differences at 30 or 60 days in either comparison.
- The AMCAH program proved to be a safe and effective alternative for eligible HF patients.
Conclusions:
- This study highlights the comparable safety and quality of an AMCAH program to traditional BAM hospitalization for HF patients.
- The findings support the viability of AMCAH for clinician-selected HF patients, suggesting it can maintain high standards of care outside the hospital.
- Further research may explore long-term outcomes and cost-effectiveness of AMCAH models.
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