Hospital-at-home programs are growing in popularity among hospitals, but the burden it adds to unpaid caregivers is one reason why 10 percent to 62 percent of families turn down the option, NPR reported July 18.
Hospital-at-home programs were a small-scale experiment until the COVID-19 pandemic made the idea mainstream. In November 2020, the federal government changed rules so hospitals could be paid the same for treating patients at home. Today, 390 hospitals in 37 states use hospital at home, according to the report.
Hospital-at-home programs are designed for people sick enough to need attention from hospital providers but stable enough to receive care at home. The programs are often used in treating diseases such as chronic obstructive pulmonary disease, heart failure, pneumonia and infection. Patients can receive twice-daily nurse visits and daily telemedicine sessions with physicians. Services such as physical therapy, oxygen machines, drugs and infusion, and blood tests also can be done at home.
Research on outcomes is inconclusive but shows promise for quality care and savings, the report said. However, family caregivers often take on responsibilities for which they might not be prepared. A survey by Brigham Health, meanwhile, found the stress and burden on caregivers were similar between traditional hospitalization and hospital at home.
A recent AARP policy briefing recommended federal policymakers require programs to ensure family members know what to expect. Currently there are no such requirements, but CMS, which oversees these programs, is considering adding rules regarding caregivers' responsibilities.
"CMS makes it very clear that during the hospital-at-home stay, hospitals are not to use family members, support persons or caregivers to provide care that would otherwise fall to nurses or other hospital staff during an inpatient admission," CMS Chief Medical Officer Lee Fleisher, MD, said in a statement to NPR. "Caregivers should have time to focus on a patient's emotional needs and overall well-being throughout the healing process."