Why we need to support the hospital in the home services
The possibility of reducing hospital length of stay while offering quality care to patients in the comfort of their own home are the primary benefits that sees hospital in the home (HITH or hospital substitute treatment) as an emerging model to treat patients with illnesses or conditions that need close care and monitoring, but who are not likely to deteriorate rapidly.
Much has already been written about the advantages, ranging from faster rates of recovery, lower readmissions and the minimal disruption this option has on the patient’s lifestyle. For hospitals, HITH enables earlier discharge of patients, which reduces the burden on the system and helps keep beds available. Additionally, there is a minor cost-saving benefit.
In the last five years, both federal and state governments have invested in the model, and a combination of the onset of COVID-19, which put pressure on hospital capacity, and improved technology, ranging from telehealth to monitoring devices, has led to a rapid uptake of HITH. It is inevitable that we will see HITH grow as technology, infrastructure, resource planning and patient awareness increase.
To make HITH work, however, we need a tripartite effort from the key players: insurers, hospital discharge planners and doctors/surgeons. Alignment between these three parties using a person-centred approach to develop goals can make a meaningful difference to the effectiveness of HITH.
Insurance companies mostly want to remain ethical and impartial with regard to which providers they use. In order to be approved as alternative treatment providers to hospital services, these providers need to have partnerships with both private hospitals and insurers to make these parties more comfortable about using them.
Moreover, insurance companies need to embrace full coverage — hospital care and allied health care — to get the most out of each provider rather than offering fragmented treatment. Support from insurers will help HITH become a person-centred care model where patients can access a full spectrum of healthcare services from home to assist with their recovery.
Hospital discharge planners
The role of a hospital discharge planner is to make arrangements for patients to move from the hospital into outpatient care, or in some cases where hospital substitute treatment is the initial option, planners will establish the resources and actions needed to maintain the patient’s care schedule.
Planners need to understand a patient’s holistic requirements, which may fall outside what the hospital offers, or include existing healthcare practitioners the patient prefers but are not available through the hospital. The inclusion of allied health services in a discharge plan can help the patient balance the resources provided by the hospital and those outside it to coordinate their care.
Doctors and surgeons also need to be aware of the partnership between insurers and providers to authorise this discharge. It is also important for these healthcare practitioners to open their minds to the many aspects of a client. This means to take into account care needs that may fall outside their discipline, or even the more familiar ‘pillar’ disciplines such as physio, so they have a better view of the whole patient.
The intersection of hospital healthcare and allied healthcare is a significant one. When healthcare practitioners understand complementary disciplines and factor them into their HITH decisions, it enables them to tailor recovery to the needs of the patient, which may also cover the lifestyle to which the patient is returning.
Let’s consider the example of a joint replacement. The hospital discharge planner recognises at admission (or even before) that the patient is an appropriate candidate for a HITH Program. They engage with an allied health provider and the patient’s PHI fund to ensure the patient has a swift discharge to receive the care they want in their own home, as opposed to on the hospital ward. This results in a better experience for the patient, great outcomes as a result of the allied health care and a saving for the insurer, when compared to funding a prolonged hospital stay.
Hospital in the Home is here to stay. As patients evaluate the advantages of in-home care, they will look to the industry to incorporate a holistic approach that in many cases will include allied health disciplines. By working together to support patients, the health sector as a whole can boost the benefits for both the individual and the healthcare system.
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