SHM Converge Scientific Abstract ePoster Gallery-Outcomes of a Hospital at Home Program in an Integrated Healthcare System

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This retrospective cohort study evaluated Kaiser Permanente San Bernardino County’s Advanced Medical Care at Home (AMCAH) program for patients with congestive heart failure from January 2021 through October 2024. Hospital-at-home programs, which deliver acute-level care in patients’ homes, expanded during the COVID-19 pandemic and have been shown to be effective for conditions like heart failure.<br /><br />Among 573 enrolled patients, most were male (60.6%) and Medicare beneficiaries (60.5%). The population was racially and ethnically diverse, including White/Caucasian (41.4%), Hispanic/Latino (32.2%), Black (19.0%), and Asian/Pacific Islander (6.0%) patients. Fifteen percent were enrolled directly from the emergency department, while 85% were admitted after early discharge from the hospital.<br /><br />Average length of stay in AMCAH decreased over time, from 3.6 days in 2021 to about 2.8–2.9 days in later years, suggesting improved efficiency. Within 30 days of completing AMCAH, 18.7% of patients returned to urgent care or the emergency department, 20.8% were readmitted to the hospital, and 3.5% died.<br /><br />Overall, the study concluded that AMCAH produced non-inferior outcomes compared with traditional hospitalization for heart failure patients. The 30-day readmission rate was below the national Medicare benchmark for standard heart failure care, and the low mortality rate supports the safety of this model. The authors recommend further research comparing AMCAH directly with inpatient care and examining longer-term outcomes.

Asset Subtitle

Barune Thapa

Meta Tag

Author List Barune Thapa, Kinnar Bhavsar, Mylinh Luca, Nancy Nguyen

Category Research

Concept Hospital-at-Home

Concept Advanced Medical Care at Home

Concept Heart Failure

Concept Hospital Readmission

Concept Inpatient Care

Distinguished Non-Finalist

Presenter Organization Kaiser Permanente Bernard J Tyson School of Medicine

Presenting Author Barune Thapa

Track Quality Improvement

Keywords

congestive heart failure

hospital-at-home

Advanced Medical Care at Home

retrospective cohort study

Kaiser Permanente

readmission rate

emergency department

Medicare beneficiaries

acute care at home

30-day mortality

Hospital-at-Home

Advanced Medical Care at Home

Heart Failure

Hospital Readmission

Inpatient Care