2023年6月22日

hospital-at-home上涨势头,医疗系统正越来越多地转向外部公司帮忙操作程序。hospital-at-home模型,一个病人接受治疗急性病治疗的计划在家里,已经存在了几十年,但COVID-19流行病引发一波快速的投资和增长的利用率,住院病床稀少。医疗研究机构Chilmark本月早些时候发布的一份报告预测hospital-at-home成长为一个3000亿美元的产业,到2028年,其中大部分增长将由第三方公司提供交钥匙服务。“这是一个复杂的过程,站起来,打开,”罗伯特·莫斯科维茨博士说,公司医疗主任家庭保健公司伯爵夫人的健康。“对于那些还没有尝试过,我认为他们看所有的齿轮在方向盘上,需要适应的地方,它可以成为绝对压倒性的。“有283家医院在37个州已经批准hospital-at-home程序,根据医疗保险和医疗补助服务中心。供应商说在家护理可以抑制再入院,缓解容量约束和省钱对病人和医院。今年早些时候发表的一项研究在家庭医学年报上发现发生率以及返回急诊hospital-at-home患者没有明显的区别于那些接受传统的住院治疗。Hospital-at-home有关住院持续的时间较短,研究发现。通过争取外部公司求助,供应商看到机会达到更多的病人在一个高效的方式和利用新资源,同时规避一些启动成本来开发自己的程序。“人开始hospital-at-home和慢性疾病管理计划(内部),他们现在都是给我们打电话,“黛博拉DiSanzo说,百思买健康,总统在2021年收购了当前健康平台。 “I think everybody started it [in-house] because they had to. … Who was running those programs? It was physicians and nurses. [But] you know physicians and nurses are already overburdened with work." Colleen Hole, administrator of hospital-at-home at Atrium, said the goal is to reach 50 patients per day by year's end, compared with the current 20-plus patients. Since launching, Atrium's program has served more than 7,000 patients with more than 150 conditions, including congestive heart failure, pneumonia and chronic obstructive pulmonary disease. Atrium also is looking to form a partnership for X-ray and ultrasound imaging support in the home, she said. “We often hear, ‘We don’t have enough acute-care beds [in hospitals],’ … and with the aging population, it’s going to exponentially increase our need for acute care," Hole said. “I would argue we do have enough beds. They’re just in people’s homes.” Worcester, Massachusetts-based UMass Memorial Health has partnered with Current Health for remote monitoring, VNA Care for physical and occupational therapy and Trident for in-home ultrasounds and X-rays. Dr. Taki Michaelidis, medical director for the system's hospital-at-home program, said one of the system's biggest challenges is ensuring personal care aides are quickly made available for patients. Home health agencies are used to fulfilling requests in a couple of days for less acute patients, he said. UMass Memorial, which launched its program in 2021, is working with local agencies to keep response times within an hour range. The nonprofit system would like to find additional partners to help with logistics across its central Massachusetts footprint. “If you leave our medical center, you can be in an urban city in five minutes, you can be in suburban areas in 10 minutes, and you can be in farmland in 15 minutes, so it’s a very, very diverse area in our part of the state,” Michaelidis said. Dr. Ania Wajnberg, a geriatrics and palliative medicine professor at the Icahn School of Medicine at Mount Sinai in New York, said operating hospital-at-home means battling decades of centralization in acute care, and Mount Sinai looks for vendors that aren't afraid to deviate from the standard. The system launched hospital-at-home in 2017 through a joint venture with Contessa, and in 2020 also began working with Current Health. Mount Sinai is open to additional partnerships and vets potential vendors based on timeliness, reliability and communication, in addition to scalability, she said. "We've really tried to find who the most innovative vendors are, which vendors are really willing to work on something that's changing healthcare," Wajnberg said. Related Articles