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Treating patients at home may be cheaper, better

A program that allows patients to be treated at home instead of the hospital can improve care and satisfaction, new research from Johns Hopkins shows.

The model called Hospital at Home reduced costs by roughly 20 percent and had equal or better outcomes among patients in New Mexico who participated in a study, published in the June issue of Health Affairs.

“Hospital at Home is an excellent model of care that can be implemented in a practical way by health delivery systems across the country and can have dramatic positive clinical and economic outcomes for patients and systems,” says Dr. Bruce Leff,  the Johns Hopkins professor who developed the model and study leader.

“This program represents what health care reform is attempting to achieve; it's a high-quality clinical program that provides patient-centric individualized care while making the most effective and efficient use of the health care dollar.”

The program may not be implemented widely just yet because of Medicare coding problems with services given at home.

But the year-long study did show that the 323 elderly patients who were sick enough to be hospitalized but were treated at home had slightly lower hospital readmission and mortality rates and almost 10 percent higher satisfaction scores. They were compared to 1,048 hospital inpatients. Lower costs resulted from shorter hospital stays and fewer lab and diagnostic tests.

They all got a daily visit from a doctor and at least a daily visit from a nurse and lived within 25 miles of an emergency room run by Presbyterian Healthcare Services of Albuquerque, N.M.

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