Hospital at Home
The patient-centred and family-friendly concept “home care” appeared on the global scene of health services at the dawn of the 20th century. This type of service has proved to be very welcome to patients and those they live with.
More recently the disquieting rise in demand for acute hospital beds has given birth to a new type of home care, which is specifically defined as the “provision of health care services to patients at home, who otherwise would have to be treated in hospital”. This type of home care, named “Hospital at Home”, is the most advanced type of home care, aiming to provide a hospital setting in the home environment.
However, Hospital at Home has much more to offer than most of the schemes reported in the literature. Incorporated in the administrative structure of a hospital as real wards, manned with doctors, nurses and other health professionals on 24-hour duty in shifts and providing frequent regular home visits by doctors and nurses, Hospital at Home can reproduce real hospital conditions in the patients’ homes.
Portable medical devices enable the performance of a wide range of examinations at home, while information and communication technology neutralizes distances and makes collaboration between the virtual team and other contributors feasible and effective.
Almost any patient whose condition neither requires prompt surgical operation, nor meets the criteria for administration to an intensive care unit, can be safely hospitalized at home, provided that he is attended by a properly organized, properly equipped and highly alert Hospital at Home service.
In the last two centuries the rapid development of technology and the substantial understanding of biology led to an increasingly sophisticated management of disease. We passed from the healers’ art to the industry of treatment. The diagnosis and treatment of disease increasingly demanded both the contribution of doctors of different specialties and the availability of expensive facilities. Therefore the model that prevailed was the hospital.
The challenge is to achieve this shift of services from hospital to home, without depriving the patient of the indisputable benefits of biotechnology and expertise found in the hospital environment.