Healthy numbers

Hospital@Home initiative produces positive results

The numbers are in. So far, 18 months into a two-year pilot project, the Prince Edward Family Health Team (PEFHT) Hospital@ Home initiative is delivering positive results—treating patients at home rather than in a hospital bed, and saving money in the process.

The Hospital@Home project began in September 2013, but didn’t receive an official kick-off until the following March. This week, the PEFHT provided results.

Hospitals are expensive places to treat sick people. It is why healthcare funders are so keen to move patients out of hospital beds as quickly as they are able—that, and the real risk of patients getting sicker from infection.

So the question arose: if you were able to keep hospital patients at home and away from the hospital, could the healthcare system treat these folks just as well, at a lower cost?

From the outset, there have been questions about whether this could work. After all, a centralized team of nurses, doctors, administrators and workers can look after a number of people simultaneously in a hospital setting. But in Hospital@ Home each of those disciplines must travel to an individual patient’s bedside—whether it is located in Milford or Consecon. Whether it is in freezing rain or at the end of a snow covered lane.

But the data presented this week indicates a small but clear measure of success. To date, Hospital@Home has seen 129 patients, 29 of whom would have otherwise been admitted to hospital, representing a total of 287 hospital days saved.

According to a Queen’s University cost benefit analysis, the Hospital@Home program has manage to shave about 20 per cent from the cost of providing the same care in a conventional hospital setting.

These are meaningful savings.

But can the program scale beyond a few dozen individuals each year? Prince Edward County Memorial Hospital recorded nearly 7,000 hospital days in 2014. The Hospital@Home program diverted 287 hospital days, a little more than four per cent.

According to Stephanie McLaren, PEFHT executive director, the answer is yes.

“There has been a marked increase in these types of admissions since late 2014,” says MacLaren, “as the program’s ability to manage more acutely ill patients has increased and the physicians within the Prince Edward Family Health Team have expressed more confidence in this alternative to hospitalization.”

She adds that it is hard to know how many of the Hospital@Home patients might have ended up in a hospital bed without the care they received from the program.

MacLaren is confident the program can grow.

“This potential has only started to be realized since October 2014,” says MacLaren. “It took a good deal of time for physicians to be comfortable with the idea of admitting patients to the program who would ordinarily be admitted to hospital based on their acuity. Building the confidence in the program was done over time, with early discharge patients.”

MacLaren acknowledges there are limits to the Hospital@Home program—that it will only be a part of the answer to rising health care costs. But she says the program is particularly well-suited to this community.

“At a time when Prince Edward County’s aging demographic is outpacing the Ontario average, H@H provides a strong and viable approach that is changing the case of rural healthcare for the better,” says MacLaren.