Wall Street Journal Examines Program Allowing People With Acute Illnesses To Receive At-Home Care

Main Category: Caregivers / Homecare
Article Date: 21 Apr 2006 - 16:00 PDT

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The Wall Street Journal on Wednesday examined a program at the Veterans Affairs Medical Center in Portland, Ore., that allows acutely ill patients to receive care at home instead of in a hospital setting. Under the program, doctors give patients diagnosed with one of four severe illnesses -- including congestive heart failure and cellulitis, a skin infection -- the choice of receiving care at home or in the hospital. To be eligible, patients must meet certain medical criteria and have a safe home environment. Once a patient chooses the home care option, a small "strike force" is activated to send the patient home with such equipment as oxygen tanks, portable x-ray machines and medicines. A nurse visits the patient every day to perform tests and other services, and a physician remains on 24-hour standby for emergencies. Patients are "discharged" once they have recovered, after an average length of stay of three days, compared with four days for hospital patients, the Journal reports. For VAMC-Portland, the primary benefit of the program is that it frees up beds at its main facility, which often operates at full capacity, according to the Journal.

Part of Growing Movement
According to the Journal, the program is part of a "fledgling movement called 'home hospital,'" launched in 1996 by researchers at the Johns Hopkins University School of Medicine. VAMC-Portland was one of three hospitals that participated in a pilot study of the system in 2000 and found that costs for home care patients were one-third less than for similar hospital patients. The study also found that those treated at home had shorter stays, fewer procedures, less delirium and higher satisfaction scores. VAMC-Portland and another facility that participated in the study continued their programs, with moderate changes, after the study ended, and to date, VAMC-Portland has successfully treated more than 300 home-based patients. Despite the success, the programs remain "a novelty" in the health care industry, the Journal reports. However, as health care costs continue to rise and baby boomers age, "cost pressures and demand for beds will only intensify," and some say the home care option is one way to address the issues, according to the Journal. "I don't think we can continue to provide hospital care the way we have" in the U.S., Scott Mader, the geriatrician who oversees the VAMC-Portland program, said, adding, "We need new models" (Naik, Wall Street Journal, 4/19).

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