Hospital at Home vs conventional hospitalization: good clinical outcomes with lower cost and nosocomial complications

Abstract Background Hospitalization at Home (HAH) is a care model safe and cost-effective as an alternative to conventional hospitalization (CH). HAH reduces hospital admissions and length of stay in the wards with comparable clinical outcomes. Published studies exhibit significant heterogeneity in data analysis methods, patient profiles, health outcomes and economic costs. Methods A retrospective observational study conducted on patients treated by our HAH service over two years (988 in 2019 and 1335 in 2023), analysing epidemiological and clinical aspects, savings in CH beds utilization, and a comparative analysis with CH of nosocomial complications, use of complementary explorations and cost differences between both resources. Results Over two years, HAH activity increased while maintaining lower complication and readmission rates compared to CH. Over 90% of HAH patients were discharged home. Although the average length of stay was longer in HAH, the cost per patient per day was significantly lower in HAH (€86 vs €215 in 2019 and €118 vs €257 in 2023), and freed up 23-31 inpatient beds daily, improving hospital efficiency. Annual savings from HAH utilization amounted to €1.1 million in 2019 and €1.5 million in 2023. Additionally, reduced use of hospital resources (laboratory, CT and MRI) in HAH saved more than €58 000 in 2019 and €100 000 in 2023. Conclusions For selected patients, including frail elderly people with multiple comorbidities, HAH is an excellent alternative to CH, that provides hospital-level medical care at home, avoiding nosocomial complications while maintaining care quality and generating substantial economic savings for healthcare system.