Hospital@Home: An innovative model for improving patient care in the home environment

What is a Hospital@Home?

H@H describes an innovative concept that enables patients to receive specialised medical treatment and care in their own four walls, which can be equivalent to hospital treatment [1].

The H@H care model is also known under other names such as "Hospital in the Home". Multidisciplinary teams - consisting of doctors, nurses, physiotherapists and other specialists - work closely together and are in continuous contact with the patients and their families [1, 2]. This ensures seamless care from the medical treatment phase in hospital through to handover to the GP practice.H@H is attracting increasing attention, particularly in the current debate about easing the burden on the healthcare system. This idea originated in countries such as the USA, Canada, the UK and Australia [3, 4]. Such models have been successfully used there for years. These countries have shown that acute care at home is possible and that the benefits are promising. In Switzerland, too, H@H is increasingly being tested and trialled in pilot projects, with various approaches being used. These include the "Hospital at Home" project at the Arlesheim Clinic (Basel; daily, hospital-equivalent treatment and care at home, possibly with additional monitoring using a telemedicine system). with additional monitoring using a telemedical monitoring system), the "spital@home" offer from the company we4you (Einsiedeln; daily visits at home by a mobile interprofessional medical team with the use of modern technologies for continuous monitoring), the "Visit - Spital Zollikerberg Zuhause®" project from Zollikerberg Hospital (Zurich; treatment at home by aninterdisciplinary team of the hospital with the use of telemedicine and monitoring technology for safety and medical supervision), the "Hospital at Home" project of Hospital at Home AG in cooperation with Klinik Hirslanden and Klinik Im Park (Zurich; daily medical and nursing rounds at home) or our SHIFT pilot study " Hospital@Home" (see section "The Hospital@Home approach of the SHIFT pilot study").

The Swiss Hospital at Home Society distinguishes between three types of H@H models, which vary according to patient needs and specific circumstances and each require different financing models:

The various H@H models represent innovative, patient-centred types of healthcare and are seen as promising in Switzerland.

What all H@H models have in common is that they enable patients to receive care in their own four walls, so that they can enjoy the comfort and support of their own home. The H@H models ensure a seamless transition from the treatment phase in hospital back to standard outpatient care.

However, H@H is not a rigid concept, but a flexible spectrum of different care models. While some programmes focus on specific diagnoses, others cover a broader spectrum of illnesses. In addition, the duration of care can vary between a few days in acute phases and longer-term support for chronically ill patients, depending on requirements. There can also be differences at an organisational level: While certain H@H programmes are directly linked to a hospital, others are the result of cooperation between various players - such as hospitals, GPs, care services or telemedicine providers.

To summarise, H@H represents a promising alternative to traditional inpatient care. The concept has the potential to fundamentally change the way medical care is organised in the future. In view of the ongoing digitalisation and ever-increasing demands on the healthcare system, H@H could play an important role in future healthcare provision.