The National Institute for Health and Care Research (NIHR) has published the results of research which found that being cared for at home is a good alternative to hospital for many older people.
The service, called hospital at home, led to no more deaths after 6 months or 1 year than among people admitted to hospital. People receiving this were less likely to be admitted to a care home (a sign they are not coping at home), and it was cheaper than hospital care. In addition, people and their carers preferred this service over hospital care.
The report says growing numbers of older people have complex needs. They may have more than one long-term condition or be living with frailty. When they develop a sudden and intense illness, they are more likely to be admitted to hospital. Hospital care is expensive, may reduce their opportunities to be mobile, and can put them at risk of infection.
However, until recently it wasn’t known if hospital at home is a good alternative. This study, which looked at 1,000 people in 9 locations across the UK, including included people aged 65 years and older who were being considered for a hospital admission, explored whether hospital at home, led by a geriatrician, would allow older people to remain in their homes for longer, compared with hospital care. It also considered whether the costs of the service (compared to hospital care) and whether it helped people to recover from illness.
A summary of the research findings is available at: NIHR Evidence - Hospital at home is a good option for many older people - Informative and accessible health and care research
Jane Townson, CEO, Homecare Association commented:
Supporting older people to live well at home, where most prefer to be, is beneficial for individuals, their families, and communities.
Preventing deterioration and admission to more expensive settings, such as care homes and hospitals, also has potential to reduce pressure on health and care services and save money.
It is therefore encouraging to see evidence that receiving healthcare services at home instead of in hospital, called “hospital at home”, leads to similar outcomes. People were no more likely to die or be admitted to a care home if they were treated at home rather than in hospital. Furthermore, hospital at home was cheaper than hospital care.
The current national strategy of pouring most of available funding into acute hospitals is failing. Excess deaths of people at home are nearly one-third higher than the 5-year average, and unmet need, ambulance response times and waiting lists for treatment are at record levels.
We call on the government to invest more in home-based and community support and care, to shift the dial on demand, improve our health and well-being, and reduce costs. As well as improving lives, this would also help to support economic recovery.
What is hospital at home?
NIHR notes that some areas in the UK already provide hospital at home for older people. The service is led by a geriatrician (a doctor who treats older people), working with a team of different NHS specialists (multi-disciplinary team). Without such a service, some of these people would have been admitted to hospital.
Hospital at home is not suitable for the most unwell older people. In addition, people using the service cannot have poor housing conditions. They need to have a home that, for example, can have handrails fitted if required, has heating and hot water.
Further information on hospital at home can be found on the NHS website.
