2023年6月22日

hospital-at-home上漲勢頭,醫療係統正越來越多地轉向外部公司幫忙操作程序。hospital-at-home模型,一個病人接受治療急性病治療的計劃在家裏,已經存在了幾十年,但COVID-19流行病引發一波快速的投資和增長的利用率,住院病床稀少。醫療研究機構Chilmark本月早些時候發布的一份報告預測hospital-at-home成長為一個3000億美元的產業,到2028年,其中大部分增長將由第三方公司提供交鑰匙服務。“這是一個複雜的過程,站起來,打開,”羅伯特·莫斯科維茨博士說,公司醫療主任家庭保健公司伯爵夫人的健康。“對於那些還沒有嚐試過,我認為他們看所有的齒輪在方向盤上,需要適應的地方,它可以成為絕對壓倒性的。“有283家醫院在37個州已經批準hospital-at-home程序,根據醫療保險和醫療補助服務中心。供應商說在家護理可以抑製再入院,緩解容量約束和省錢對病人和醫院。今年早些時候發表的一項研究在家庭醫學年報上發現發生率以及返回急診hospital-at-home患者沒有明顯的區別於那些接受傳統的住院治療。Hospital-at-home有關住院持續的時間較短,研究發現。通過爭取外部公司求助,供應商看到機會達到更多的病人在一個高效的方式和利用新資源,同時規避一些啟動成本來開發自己的程序。“人開始hospital-at-home和慢性疾病管理計劃(內部),他們現在都是給我們打電話,“黛博拉DiSanzo說,百思買健康,總統在2021年收購了當前健康平台。 “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