Home Care vs. Hospitalization: When to Choose Home Care?
The Family Environment as a Tool for Therapy and Preventing Hospitalization
Receiving healthcare at home, when possible, offers numerous benefits compared to traditional hospitalization. The patient remains in their familiar environment, surrounded by loved ones and personal belongings, which reduces stress and disorientation.
Scientific Evidence Supporting Home Care
Studies and patient testimonials confirm that many individuals feel more comfortable, safe, and engaged at home. A recent JAMA study found that most patients report faster recovery and greater safety with home-based care.
Advantages of Home Care for Chronic Patients
Home care significantly benefits patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD) or diabetes. The comfort of home facilitates adherence to treatment plans and improves sleep quality, often neglected in hospitals, which is especially crucial for elderly and chronic patients.
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Risks of Hospitalization for the Elderly
Hospitalization stress can trigger acute confusion, increasing delirium risks in elderly patients. Recent geriatric studies highlight that prolonged hospital stays can lead to delirium and confusion, extending recovery time and increasing complications and costs.
Concrete Data on Hospital Delirium
A European study revealed that hospital delirium extends stays by 5-10 days, raising per-patient costs by 30%. Assisting elderly patients at home reduces these risks by maintaining their orientation, daily routines, dignity, and autonomy.
Advice on coping with cognitive decline at home
Home Care and Reducing Infections
Reduced Infections and Complications
A key advantage of home care is the reduced risk of hospital-acquired infections, known as nosocomial infections. Vulnerable patients face higher infection risks in hospitals, such as pneumonia or urinary infections, which are less likely at home.
Mobility and Prevention of Clinical Deterioration
Patients can move and rest more naturally at home, aiding functional recovery. International data suggest that hospital-at-home programs can achieve clinical outcomes equal to or better than traditional hospitalization.
Superior Outcomes with Home Care
A U.S. report indicated that acute care delivered at home resulted in lower mortality rates and fewer complications than traditional hospital care. Patients and caregivers reported high satisfaction with home care outcomes.
Case Study: Treatment of Pneumonia
Patients with community-acquired pneumonia treated at home with intravenous antibiotics administered by specialized nurses had a 40% reduced risk of nosocomial infections compared to hospitalized patients.
Psychological Benefits and Supporting Technologies
Home care patients show lower risks of hospital-acquired conditions and reduced levels of depression and anxiety compared to hospitalized individuals. Portable medical devices, such as home oxygen therapy or remote cardiac monitoring, enhance safety and efficacy. When well-organized, home care is both clinically safe and often preferable.
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What Does Home Care Entail?
Long-term Health Benefits and Hospitalization Prevention
Specialized home care enables continuous monitoring and early intervention, preventing condition deterioration and hospitalization, particularly in chronic disease management. Chronic patients monitored at home by nurses and doctors are less likely to need emergency room visits for acute conditions.
Example: Managing Heart Failure
Successful home-based management of heart failure by adjusting diuretic therapy at early signs prevents acute emergencies. A notable case from CAD Ticino involved regular remote monitoring, preventing three emergency visits for a patient with heart failure.
Detailed CAD Home Intervention for Chronic Patients
An example involves remotely monitoring vital parameters. The CAD nursing coordinator managed an event for Mrs. B, an 84-year-old patient with COPD, heart failure, overweight, and immobility syndrome. Continuous 24-hour advanced multiparametric monitoring detected cardiac anomalies, confirmed by blood tests and clear symptoms. Immediate home treatment, in collaboration with her physician, ensured patient stability.
Timely Treatment at Home
Up to 15-20% of emergency care and 25% of post-acute care can be delivered at home with equal quality and cost savings. Technology, such as wearable devices for vital monitoring and teleconsultation platforms, allows real-time medical interventions, drastically reducing avoidable hospital admissions. CAD Ticino, a Swiss home care service, aims to reduce hospitalizations by offering intensive, specialized home care as an effective alternative, contributing to a calmer patient experience, hospital decongestion, and healthcare sustainability.
Economic Savings of Home Care for Healthcare Systems
Costs of Hospital Stays vs. Economic Benefits of Home Care
Well-organized home care is typically less expensive than hospital stays, which involve high overhead costs (24-hour staffing, infrastructure, tests). Home care covers only the services and materials actually used.
Reduced Expenses in Home Care
International experiences, like the Medicare Hospital-at-Home program in the U.S., showed significant post-hospital savings for patients continuing care at home. In Switzerland, similar models demonstrate significant cost savings while improving patient well-being.
Concrete Data from Ticino
An economic analysis in Ticino, Switzerland, estimated average savings of CHF 2,500-3,000 per care episode compared to hospital stays. Fewer hospital days lower overall healthcare expenses and complication-related costs. Collaboration between hospitals and home services, like CAD Ticino’s partnership with local clinics, ensures smooth transitions and reduces hospital readmissions.
Better Quality and Patient Satisfaction with Home Therapies
Personalized Care and Psychological Benefits
Home care offers personalized, patient-centered approaches, adapting interventions to individual needs and preferences. Patients stay actively engaged in their care, enhancing therapy adherence and satisfaction. Feedback from pilot projects confirms high patient satisfaction.
Home Hospitalization Satisfaction Data
Research from the U.S. found that nearly half of patients view home hospitalization as a fully acceptable alternative, with the majority believing home recovery is faster. This aligns with experiences in Ticino, Switzerland, where CAD’s integrated approach improves quality of life and supports patient independence within a sustainable healthcare model.
Preventing Hospitalizations: Proactive Home Care
Prevention as a Healthcare Strategy
“Prevention is better than cure,” especially for vulnerable individuals. Early home care services monitor health proactively, addressing issues like weight loss, unstable blood sugar, or altered vital signs before hospitalization is needed. Pilot programs in Ticino, Switzerland, reduced preventable emergency visits by 25%.
Post-discharge Management
Effective post-discharge planning with home care reduces hospital readmissions, ensuring follow-up, medication management, wound care, and rehabilitation.
Preventing “Social” Hospitalizations
Home support prevents unnecessary hospital admissions by addressing loneliness and the inability to self-manage, avoiding “social” hospitalizations.
Conclusion: A Future-oriented Care Model
Revolutionizing Home Medicine: Innovative Technologies for Personal Well-being
Home care isn’t just an alternative; it revolutionizes healthcare by promoting psychological well-being, minimizing clinical risks, and optimizing economic resources. Integrating innovative technologies like telemedicine and remote monitoring, alongside collaboration between hospitals, family doctors, and home services, shapes the future of personalized healthcare.
Investing in specialized home services like CAD Ticino’s creates a patient-centered healthcare system, improving quality of life and making optimal care accessible at home.
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Sources and Further Reading:
- Leff, B., et al. (2015). “Comparison of functional outcomes associated with hospital at home care and traditional acute hospital care.” Journal of the American Geriatrics Society, 63(2), 224-231.
- Caplan, G. A., et al. (2017). “Hospital in the home: A randomized controlled trial of home-based versus hospital-based care for older people.” Medical Journal of Australia, 207(10), 431-436
- Federman, A. D., et al. (2020). “Hospital at Home: A systematic review of efficacy and safety.” Annals of Internal Medicine, 172(11), 743-751.
Levine, D. M., et al. (2020). “Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial.” Annals of Internal Medicine, 172(2), 77-85. - Shepperd, S., et al. (2016). “Admission avoidance hospital at home.” Cochrane Database of Systematic Reviews, 9, CD007491.
Noah, B., et al. (2020). “Impact of remote patient monitoring on clinical outcomes: An updated meta-analysis of randomized controlled trials.” NPJ Digital Medicine, 3, 11. - American Heart Association. (2021). “Digital health and telemedicine in heart failure management.”
- Gonçalves-Bradley, D. C., et al. (2020). “Discharge planning from hospital.” Cochrane Database of Systematic Reviews, 4, CD000313.
- Klein, S., et al. (2019). “Patient and caregiver perspectives on hospital at home.” Journal of Patient Experience, 6(4), 279-285.
