Perioperative Hospital-at-Home Program: A Scoping Review

Hospital-at-Home (HaH) is an established model of care for medical patients, particularly following rapid expansion during the COVID-19 pandemic. In contrast, perioperative HaH remains in its early stages, with limited understanding of appropriate care delivery models, staffing, feasibility, cost-effectiveness, and relevant clinical outcomes. Surgical-specific demands limit the operational transferability of HaH from nonsurgical care. This scoping review synthesizes existing evidence on perioperative HaH to clarify current practices and identify key domains for future research and implementation.

A systematic search strategy was developed for MEDLINE (via PubMed) and adapted for Embase and Scopus to identify studies involving adults undergoing surgery who received HaH care. After data extraction, a narrative synthesis was conducted to map care delivery and staffing models and the domains of reported clinical outcome measures.

The search identified 5612 records, of which 18 studies met the inclusion criteria. The studies were published between 1991 and 2024 and originated mainly from the United Kingdom, Spain, and the United States. Care-delivery models and clinical outcome measures were heterogeneous, particularly those relating to patient safety. Orthopedic procedures were most common, followed by bariatric surgery and other general surgical specialties. Most studies evaluated postoperative HaH pathways, with only two examining preoperative models. Surgical admissions were predominantly elective, although some included emergency populations.

Perioperative HaH shows promise as a rapidly evolving model of perioperative care, but the current evidence base is limited by small, largely noncomparative studies and a lack of standardized outcome measures. This is the first scoping review to systematically map perioperative-specific HaH models across pre- and postoperative phases and surgical specialties. Strengthening the quality of evidence is essential to inform policy, guide best practices, and support the safe and scalable adoption of perioperative HaH programs.