Hospital at Home as a Treatment Strategy for Worsening Heart Failure

Author:

Haywood Hubert B.1ORCID,Fonarow Gregg C.2ORCID,Khan Muhammad Shahzeb3ORCID,Van Spall Harriette G.C.45ORCID,Morris Alanna A.6ORCID,Nassif Michael E.7,Kittleson Michelle M.8ORCID,Butler Javed910ORCID,Greene Stephen J.311ORCID

Affiliation:

1. Department of Medicine, Duke University Medical Center, Durham, NC (H.B.H.).

2. Division of Cardiology, Ahmanson-UCLA Cardiomyopathy Center, University of California Los Angeles Medical Center (G.C.F.).

3. Division of Cardiology, Duke University Medical Center, Durham, NC (M.S.K., S.J.G.).

4. Department of Medicine (H.G.C.V.S.), McMaster University, Hamilton, ON, Canada.

5. Population Health Research Institute (H.G.C.V.S.), McMaster University, Hamilton, ON, Canada.

6. Emory University School of Medicine, Atlanta, GA (A.A.M.).

7. Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City (M.E.N.).

8. Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (M.M.K.).

9. Baylor Scott and White Research Institute, Dallas, TX (J.B.).

10. Department of Medicine, University of Mississippi, Jackson (J.B.).

11. Duke Clinical Research Institute, Durham, NC (S.J.G.).

Abstract

Hospital at home (HaH) is an innovative care model that may be particularly suited for heart failure (HF). Outpatient visits and inpatient care have been the 2 traditional settings for HF care, yet may not match the social and medical needs of patients at all times. Alternative models such as HaH may represent an effective and patient-centered option for select patients with worsening HF. To date, limited research in HF and other disease states has supported HaH as being safe and lower cost than traditional inpatient admission. Supporting HaH are new payment structures, such as Medicare’s Acute Hospital Care at Home waiver program. In combination with outpatient visits, outpatient intravenous diuretic clinics, inpatient care, and cardiac intensive care, HaH could be a core component of a comprehensive care model with the potential to match resource utilization with the needs of patients across the spectrum of HF severity, and improve patient outcomes.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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