Acutely ill patients who received virtual and home care with remote patient monitoring and in-person urgent care visits when needed had shorter hospital stays than those who received standard hospital care, according to a new study. Shown.
For this study, researchers evaluated the Safer@Home care model launched at Los Angeles General Medical Center in September 2022. This care model is an expansion of the virtual home acute care model launched in 2020 for patients with novel coronavirus disease (COVID-19) pneumonia. Requires oxygen. The Safer@Home model addresses a wide range of acute conditions, including exacerbations of heart failure, bacterial pneumonia, and diabetic foot infections.
The Safer@Home model is similar to the home health care model popularized by the federal Acute Hospital Care at Home (AHCAH) waiver. This allows hospitals to waive certain Medicare participation requirements and provide acute hospital-level care in the home. . However, even under the waiver, hospitals must adhere to some Medicare standards, such as taking vital signs three times a day at patients' homes. Therefore, AHCAH participating hospitals require additional nursing staff and, in some cases, extended travel time.
As a result of these challenges, the Los Angeles County Health Department has been unable to implement the AHCAH program, the study authors noted. Instead, eligible patients are discharged home and receive care through virtual clinical services, remote patient monitoring services, oral or inhaled therapy, and repeat urgent care visits if in-person care is required, Safer@Home. I created a model. This model does not involve home care workers.
Researchers evaluated patient outcomes of the Safer@Home program from its launch on September 1, 2022, through August 31, 2023. They compared data from 876 Safer@Home patients with data from 1,590 matched controls, patients with similar symptoms. Diagnosers who received standard inpatient treatment during the study period.
This study showed that the overall average length of stay for Safer@Home patients was significantly shorter (1.3 days) compared to matched control patients (5.3 days).
There was no significant difference in the proportion of Safer@Home patients and control patients who had at least one emergency department (ED) visit and were readmitted within 30 days. However, patients in the Safer@Home cohort had a significantly lower average per capita ED visit rate than control patients during follow-up.
Furthermore, there was no significant difference between the mortality rates of the two groups at 30 days.
This study showed that Safer@Home patients had significantly more return visits to the emergency room. Approximately 37.3% of Safer@Home patients required 538 return urgent care visits, while only 5.2% of control patients required 132 urgent care visits. According to the researchers, this was a deliberate “trade-off to significantly reduce hospital stays.”
“The use of advanced emergency medicine is a follow-up mechanism specifically intended for this program, replacing inpatient treatment at home when remote monitoring of a patient's symptoms and vital signs requires an in-person assessment. It was intended to replace medical and emergency visits,” they wrote.
Therefore, they concluded that the Safer@Home model could be a viable alternative to home care programs that require staff to visit patients' homes.
The study comes amid growing evidence that acute care can be delivered safely and effectively in patients' homes.
A study published in October 2024 provided a detailed analysis of the AHCAH program and showed that it produced high-quality outcomes. The study, conducted by CMS, collected data from 365 health care facilities with approved waivers as of October 7, 2024, and analyzed several aspects of the AHCAH initiative.
This study showed that the quality of care provided under the AHCAH program is comparable to or better than the quality of care provided in brick-and-mortar inpatient settings. The study also found that hospitals participating in AHCAH had lower mortality rates than brick-and-mortar hospitals.
Anuja Vaidya has been covering the healthcare industry since 2012. Currently, I am responsible for the field of virtual healthcare, including telemedicine, remote patient monitoring, and digital therapeutics.
