Home Hospital for Suddenly Ill Adults: A Clinical Trial

What this Trial Is About

Hospitals are the usual care setting for acute illnesses in the United States, but they can be costly and carry risks, especially for older adults. Many patients experience complications such as delirium, hospital-acquired infections, and lasting loss of function. Access to timely hospital care is often difficult due to overcrowding and long emergency department waits. This research aims to assess a home hospital model that provides acute care at home with similar quality and safety, while potentially reducing costs and improving patient experience compared to traditional hospital stays. The home hospital model offers many of the same medical services available in an acute care hospital, including care from doctors, nurses, and case managers, blood tests, vital signs monitoring, telemetry, x-rays, ultrasound, intravenous therapy, and oxygen or nebulizer treatments. Additional support such as food services, home health aides, physical and occupational therapy, and social work may be provided based on patient needs. Advanced technology like point-of-care blood diagnostics, continuous vital signs and activity tracking, and 24/7 video visits with clinicians are part of the care. If urgent in-person assistance is needed, emergency services will be called to transfer the patient back to the hospital. Participants will return home after initial evaluation and treatment in the emergency department and receive tailored home hospital services. They will be interviewed at discharge and 30 days after discharge about their hospitalization and health. Researchers will measure costs, length of stay, readmissions, medical tests, patient activity, sleep, quality of life, satisfaction, and safety indicators such as delirium and hospital transfers. The study is sponsored by Brigham and Women's Hospital and aims to evaluate total direct costs from admission to discharge, typically about four days.

Home Hospital for Suddenly Ill Adults