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Hospital In The home

​​​​​Receiving care at home

Hospital In The Home (HITH) services in NSW provide acute, sub-acute and post-acute care to children and adults residing outside hospital, as a substitution or prevention of in-hospital care.

Substitution – the defining feature is that if the patient is not receiving the HITH service, the patient would require hospitalisation or a longer stay in hospital.

Prevention – care that does not immediately substitute ​for a hospital stay, however it is provided as a preventative option to avoid an imminent hospital admission or readmission.

A person may receive their care at home (including Residential Aged Care Facilities) or in an ambulatory setting that may include a hospital, community clinic setting, school or workplace.

HITH care is short-term and preferably interdisciplinary, including doctors, nurses and allied health practitioners.​

 

HITH in the Western NSW Local Health District – the following Health Services currently offer HITH programs

  • Bathurst
  • Dubbo
  • Orange
  • Parkes – commenced September 2014

Evidence shows that both people and the health system benefit from access to acute care in alternate settings to in-patient care. These benefits include improved outcomes in clinical markers such as reduced levels of confusion and delirium in people who are cared for at home, high levels of acceptance of these models by General Practice with no increase in carer burden. Using Hospital in the Home when appropriate enables hospital teams and hospital beds to be managed more efficiently and effectively.

In a recent extensive meta-analysis of randomised controlled trials comparing HITH and in-hospital care, Caplan et al (2012) showed unequivocally that HITH is safer and more efficient. The study analysed health outcomes, costs and patient and carer satisfaction, showing:

  • 19% reduction in mortality
  • For every 50 patients treated in HITH, one life will be saved
  • 23% reduction in readmission to hospital
  • HITH costs 26.5% less than in-hospital care
  • High patient & carer satisfaction​