The impact of a hybrid hospital at home program in reducing subacute rehabilitation referrals

Abstract

AbstractPurposeThe purpose of this study was to validate Hospital at Home as an appropriate care option for patients of certain diagnostic-related groups and acuity levels.Patients and methodsWe compared outcomes for patients in a Hospital at Home program at Virtua Health in 2022 (N = 272) to traditional inpatients at Virtua hospitals during the same year who did not participate in the Hospital at Home program (N = 13879). We defined outcomes as recommendations for subacute rehabilitation (SAR) and final disposition upon inpatient discharge. Specifically, we searched electronic medical records for terms related to recommendation for SAR and discharge to SAR using text mining algorithms and a natural language processing (NLP) model to confirm these recommendations.ResultsWe observed that the proportion of patients in the Hospital at Home program that were recommended for SAR (0.147) was significantly different from the proportion of patients who remained in the hospital (0.361). Further, of those patients who received a recommendation, only 1 patient in the Hospital at Home group was discharged to SAR, while nearly half of those in the control group (proportion = 0.499) were transferred to SAR.ConclusionThe Hospital at Home program is a promising alternative to traditional inpatient care for patients with certain diagnoses and who meet certain clinical criteria.