TRENDS
BY GRAHAM GARRISON
Hospital @ Home More and more providers are turning to acute care in the home. But how effective, and safe, is the new model?
When Bruce Leff, MD, is in his office space at Johns Hopkins seeing an older
“You want patients who absolutely
adult who is acutely ill, he thinks very hard on whether hospital admission is the best choice.
meet threshold requirements for an
“I know I can take care of the heart failure, or the pneumonia, or anything else,” he said,
inpatient hospital stay, but they’re not
“but will they end up worse for wear, just by virtue of having been in the hospital?”
so sick that they need an ICU or have
It’s a question hospitals and health systems have been grappling with for decades, in-
a high risk of deteriorating during the
cluding Johns Hopkins. And it’s one that came front and center during the pandemic as
hospital stay, so we developed those
providers, strained by volume and workforce shortages shifted to new models of care.
kinds of criteria,” said Dr. Leff, profes-
Researchers started to think about the ability to provide acute hospital-level care
sor of medicine and the director of the
in the home, instead of the bricks and mortar hospital in the mid-90s. Questions they
Center for Transformative Geriatric
asked themselves included: Who should be treated in Hospital At Home? What condi-
Research at the Johns Hopkins Univer-
tions? How do you choose the right patients?
sity School of Medicine.
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February 2022 | The Journal of Healthcare Contracting
