Health
Home hospital care brings ‘phenomenal’ benefits to patients and providers, study finds
A growing number of patients and providers are heralding the benefits of bringing hospital care into private homes — but a lack of permanent federal funding could put such programs at risk.
The shift to in-home care began with the onset of COVID in March 2020, when the Centers for Medicare and Medicaid Services (CMS) launched its Acute Hospital Care at Home waiver program in response to a shortage of beds.
The program enables hospitals to receive the same reimbursement for home care as they would for patients who are treated in actual facilities.
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Since the program’s launch, hundreds of hospitals in 37 states have implemented home care for thousands of patients.
One of those is the Mass General Brigham (MGB) network in downtown Boston, which launched its Healthcare at Home program in 2016.
A growing number of patients and providers are heralding the benefits of bringing hospital care into people’s homes, though a lack of permanent federal funding could put such programs at risk. (Mass General Brigham)
MGB’s Home Hospital is one of the largest in the country, serving 66 neighborhoods from five of its facilities.
Since its launch, the program has had over 2,400 home hospital admissions, translating to more than 12,700 acute care bed days saved, according to a press release from the hospital.
Dr. Stephen Dorner, chief clinical and innovation officer at MGB Healthcare at Home, talked to Fox News Digital about the program’s growth and goals, as well as the benefits for patients and providers.
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“In January 2022, we had an average census of nine patients — today, we have an average census of 36 patients with an overall capacity for 40,” he said in a Zoom interview.
“We will continue to grow that in the months and years ahead until we ultimately shift at least 10% of current inpatient volume out of hospitals and into patients’ homes.”
Dorner sees home-based care as a viable solution for the “massive capacity crisis” facing the nation’s hospitals.
Patients are “more willing to accept home hospital care because they spend so much time dealing with their chronic illness and they’d like to be able to spend more time at home,” said one doctor. (Mass General Brigham)
“Health care just costs too much money,” he said. “And especially as we look at the aging baby boomer generation and the amount of care they’re going to need — particularly as longevity increases — we have to find new, lower-cost ways to do things.”
The ability to deliver acute inpatient care in people’s homes is a “phenomenal” way to improve overall access to care and reduce medical costs, Dorner noted.
Patients’ demand for home care
While home hospital care isn’t for everyone, many patients are more than willing to receive it.
“The patients who are most willing to accept home hospital care are those who are most in tune and aware of what their medical needs are,” Dorner told Fox News Digital.
“Health care just costs too much money … We have to find new, lower-cost ways to do things.”
That typically includes patients with chronic conditions that may lead to frequent hospitalizations, such as heart failure or chronic obstructive pulmonary disease, he noted.
“They’re more willing to accept home hospital care because they spend so much time dealing with their chronic illness and they’d like to be able to spend more time at home,” the doctor said.
MGB has also had “great success” in admitting patients with new, acute issues that they’ve never dealt with before, such as cellulitis, kidney infection or pneumonia, Dorner added.
The corporate offices of Massachusetts General Brigham hospitals is pictured in Assembly Square in Somerville, Massachusetts, on Jan. 27, 2022. Mass General Brigham launched its Healthcare at Home program in 2016. (Getty Images)
“Folks want to have the creature comforts of being in their own bed, eating their own food, petting their dog as they’re recovering, being able to have loved ones come and visit, and not having to trek into the city and pay for parking and all of those things,” he said.
Patients enjoy the personalized nature of in-home care, Dorner also said.
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“About 60% to 70% of our visits are actually conducted in the home, not virtually,” he said. “So we’re sending physicians, nurse practitioners and physician assistants into the homes of our patients to be able to see them firsthand, which gives them a unique vantage point of understanding the patients’ home environment.”
He added, “Many of the patients tell us they never want to receive hospital-based care again. They want to know how they can get all of their care from the comfort of their own home.”
“The patients who are most willing to accept home hospital care are those who are most in tune and aware of what their medical needs are,” the chief clinical and innovation officer at MGB Healthcare at Home told Fox News Digital. (Mass General Brigham)
The program also has the potential to alleviate provider burnout.
“We’ve heard from our clinicians that the time they spend in home hospital care delivery is among the most meaningful encounters they’ve had in their entire careers,” Dorner said.
That doesn’t mean that all care can be brought into the home, however.
“We’re not building ICUs in the home, and we’re not looking to conduct surgeries in anybody’s living room,” Dorner said.
“But in the right conditions, we’d like to be able to build a complement in the home-based environment.”
“We’re not building ICUs in the home, and we’re not looking to conduct surgeries in anybody’s living room.”
Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, also voiced her support of the home hospital model.
“With appropriate patient selection, acute hospital care at home is an important care model to continue,” said Johnson, who is not involved with MGB’s program or research.
Researchers found that the patients who received home care had low rates of mortality (0.5% during hospitalization and 3.2% at 30 days). (Mass General Brigham)
“For certain medical conditions, the quality of care and outcomes appear equal to or better than in-hospital care,” she added.
“In particular, some studies have found fewer complications from inactivity, such as pressure sores, reduced need for skilled nursing facilities, and lower hospital readmission rates.”
Proven benefits
To measure the outcomes of its Home Hospital program, MGB researchers recently conducted a study that was published in Annals of Internal Medicine.
The team analyzed the outcomes of 5,858 U.S. patients who received home hospital care between July 1, 2022, and June 30, 2023.
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The patients in the study had “medically complex conditions,” including 42.5% with heart failure, 43.3% with chronic obstructive pulmonary disease, 22.1% with cancer and 16.1% with dementia, the researchers noted.
The five most common discharge diagnoses were heart failure, respiratory infection (including COVID), sepsis, kidney/urinary tract infections and cellulitis.
The researchers found that the patients who received home care had low rates of mortality (0.5% during hospitalization and 3.2% at 30 days). Only 62.2% of them were “escalated” to the hospital.
Within 30 days of discharge, 2.6% of patients used a skilled nursing facility and 15.6% were readmitted, the MGB researchers found. (iStock)
Within 30 days of discharge, 2.6% used a skilled nursing facility and 15.6% were readmitted, numbers the researchers described as lower than expected.
“Home Hospital is serving very complex and acutely ill patients — these are not ‘cherry-picked’ patients,” study co-author David Michael Levine, M.D., clinical director for research and development for MGB’s Healthcare at Home, told Fox News Digital.
“This is the first time we’ve been able to show the true complexity and acuity of patients cared for in this model on a national basis.”
The researchers also concluded that Home Hospital delivers “equitable care across traditionally underserved populations,” Levine said.
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“We know that traditional hospital care has large disparities in outcomes across underserved groups, and we don’t see that with Home Hospital.”
Johnson, who reviewed the findings of MGB’s study, said she found them to be consistent with previous research.
“This study of acute hospital care at home showed low rates of mortality, hospital escalation and skilled nursing facility use,” she told Fox News Digital. “These positive outcomes were seen for socially vulnerable patients as well.”
Providers are concerned that the Acute Hospital Care at Home program is still a temporary payment mechanism, as the waiver is set to expire in Dec. 2024. (iStock)
The study was limited, however, as it was based on observational data and did not have the capability to compare the numbers to in-hospital patients.
“Comparing home hospital patients to traditional hospital patients takes a lot of additional research,” said Levine. “We wouldn’t want to compare home hospital patients to, say, surgical patients or labor and delivery patients.”
He added, “If you simply look at all hospitalizations, yes, these numbers are better — but that is not a worthwhile comparison. We are currently undertaking this more advanced analysis.”
Barriers to home hospital care
Providers are concerned that the Acute Hospital Care at Home program is still a temporary payment mechanism.
The waiver is set to expire in Dec. 2024 unless Congress takes action to extend it or make it permanent.
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“A permanent payment mechanism is critical in order for more people to have access to Home Hospital care,” Levine told Fox News Digital.
“We wanted to conduct this national analysis so there would be more data for policymakers and clinicians to make an informed decision about extending or even permanently approving the waiver to extend opportunities for patients to receive care in the comfort of home.”
The shift to in-home care began with the onset of COVID in March 2020, when the Centers for Medicare and Medicaid Services launched its Acute Hospital Care at Home waiver program in response to a shortage of beds. (iStock)
When contacted for comment, the American Hospital Association (AHA) provided a statement.
“Emerging evidence suggests hospital care at home is safe, effective and useful to many patients. The AHA supported last year’s congressional extension of the regulatory flexibilities that have enabled hospitals to continue their hospital at home programs, and is working to ensure this innovative model of care remains available to patients and communities.”
Fox News Digital reached out to the Centers for Medicare and Medicaid Services (CMS) requesting comment on the potential extension of the Acute Hospital Care at Home waiver program.
For more Health articles, visit www.foxnews.com/health.
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Fireworks have been a quintessential part of Fourth of July celebrations across the nation for generations.
But as Independence Day festivities light up the night sky, the colorful displays can also pose serious health risks — especially to the lungs.
Nearly 300 million pounds of fireworks are released into the atmosphere each year in the U.S., according to the American Lung Association. This creates smoke filled with tiny particles, as well as gases like sulfur dioxide, carbon dioxide and carbon monoxide, which are “very harmful to our lungs.”
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The smoke from fireworks can also release harmful metals, like aluminum, manganese and cadmium, into the air.
Some illegal fireworks may contain lead, which the association describes as “extremely dangerous” due to its potential to cause lasting health damage.
Attendees watch the Independence Day fireworks display along the National Mall in Washington, D.C. (Probal Rashid/LightRocket via Getty Images)
“Inhaling any of these chemicals can irritate the lungs, making it hard to breathe and causing serious health problems, which is why it is important to avoid firework smoke whenever possible,” the group said in a public advisory.
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Air pollution levels increase by an average of 42% on the Fourth of July, according to a 2015 study.
Smoke from fireworks can worsen symptoms and cause flare-ups in those who have asthma or chronic obstructive pulmonary disease (COPD).
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Fine particle pollution has also been linked to more serious health consequences, including heart attacks, stroke, lung cancer and premature death, according to the American Lung Association.
The organization warned that children, older adults and pregnant women, as well as people with lung and heart disease, are especially vulnerable.
Smoke from fireworks can worsen symptoms and cause flare-ups in those who have asthma or chronic obstructive pulmonary disease. (iStock)
Dr. Afif El-Hasan, member of the Lung Association’s board of directors, shared some advice for high-risk fireworks spectators in an interview with Fox News Digital.
Instead of using fireworks at home, El-Hasan recommends watching them from a distance.
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People with asthma who use a rescue inhaler should keep it close at hand in case fireworks trigger wheezing or other symptoms, the expert advised. Wearing a well-fitting N95 mask can also help reduce exposure to fine particles from fireworks smoke and debris.
“If you are familiar with the area and the wind patterns, try to be upwind from the fireworks display and avoid areas where smoke may accumulate,” he said.
An expert recommends watching fireworks from a distance to avoid exposure to air pollution. (iStock)
The expert also recommends attending fireworks events with friends or family, so someone is available to help if a medical emergency arises.
“Make sure you have taken all of your preventative medication before a fireworks show,” El-Hasan advised. “If possible, take a car to the fireworks display. Try to park as close as possible to the event in case you have to get to the car quickly.”
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The expert also recommends drinking water immediately after the show to clear the upper airway. Changing and washing clothes upon returning home can also help to prevent smoke particles from accumulating in the home.
If case of shortness of breath or chest pain, it’s important to seek medical care immediately.
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A study of World Trade Center responders found that PTSD is associated with molecular changes linked to accelerated biological aging and a higher risk of chronic disease.
The study, led by Stony Brook University in New York, could offer new clues to the long-term physical health effects of post-traumatic stress disorder.
The researchers tested blood samples from 393 WTC responders, collected approximately 18 years after the September 11, 2001, attacks, according to a university press release.
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Out of the sampled responders, 232 were diagnosed with PTSD and 161 were not. Between the two groups, 114 proteins and seven metabolites were significantly different.
Firefighter Gerard McGibbon, of Engine 283 in Brownsville, Brooklyn, prays after the World Trade Center buildings collapsed on September 11, 2001. (Mario Tama/Getty Images)
In particular, the researchers detected changes in blood markers linked to brain function, immune activity, energy metabolism, protection against cell damage and how cells communicate and repair tissues.
Also reported were signs of accelerated biological aging in multiple organs — including the heart, kidneys, liver and lungs — among responders with PTSD.
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These discoveries could help explain why people with long-term PTSD are at greater risk for chronic conditions such as heart disease, lung disease, cognitive decline and other age-related illnesses.
“This study found that chronic PTSD is associated with long-lasting biological changes throughout the body, affecting multiple organs and biological systems decades after their traumatic exposure,” lead study author Benjamin Luft, director and principal investigator at the Stony Brook WTC Wellness Program, told Fox News Digital.
“Traumatic experiences can produce lasting biological changes that persist for decades.”
The study reinforces the view that PTSD is a “whole-body illness” rather than simply a mental health disorder, he noted.
“Traumatic experiences can produce lasting biological changes that persist for decades,” Luft said. “These changes appear to accelerate aspects of biological aging and may increase the risk of many chronic diseases.”
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Several proteins that are critical for healthy brain function were also altered in those with PTSD, the researchers found.
“Many of these proteins play critical roles in helping brain cells communicate with one another, repair damage and maintain healthy connections that support memory and thinking,” Luft said.
A New York firefighter is pictured amid the rubble of the World Trade Center following the 9/11 attacks in 2001. (Universal History Archive/Universal Images Group via Getty Images)
The study – which was funded in part by the CDC, the National Institute for Occupational Safety and the National Institutes of Health – was published in Nature Communications.
Luft said the findings should be viewed with “cautious optimism.”
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“The research provides compelling evidence that PTSD is associated with long-lasting biological changes throughout the body, including signs of accelerated aging, altered metabolism and changes in proteins involved in brain health,” he said.
“These findings strengthen the growing recognition that PTSD is not simply a mental health disorder, but a condition that can have lasting effects on physical health as well.”
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Dr. Marc Siegel, Fox News senior medical analyst, was not involved in the study but called the results “fascinating.”
“This speaks to the complex reality that PTSD is not an isolated psychiatric event due to emotional trauma alone, but that it is also tied in with physical trauma,” he told Fox News Digital. “The stress is both emotional and physical, and leads directly to immune dysregulation and aging processes.”
“These findings strengthen the growing recognition that PTSD is not simply a mental health disorder, but a condition that can have lasting effects on physical health as well,” the researcher said. (iStock)
“The chronic diseases that resulted from high exposure in the aftermath of the 9/11 World Trade Center attacks were conjoined in terms of the impact on physical and emotional well-being, longevity and effects on multiple organ systems, as well as core metabolic and immunological processes,” the doctor added.
Study limitations
There were some limitations to the findings, the researchers noted.
“Because all measurements were taken at one point in time, the research can only show an association — not that PTSD directly caused the changes,” Luft noted.
“We are currently doing studies in these patients examining multiple time points to see whether the changes in specific proteins and metabolites precede clinical changes.”
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Also, because the study was done on a unique population – World Trade Center responders who experienced very specific trauma and environmental exposures – the findings may not apply to everyone with PTSD, “such as combat veterans, survivors of abuse or people who experienced other types of trauma.”
Several proteins that are critical for healthy brain function were also altered in those with PTSD, the researchers found. (iStock)
Women are not well-represented in the study, comprising only 10% of responders.
“Blood tests cannot tell us exactly what is happening inside the brain,” Luft said. “Although many of the altered proteins are related to brain function, blood measurements are only an indirect reflection of processes occurring in the brain.”
Looking ahead
Additional studies are needed to determine whether these blood markers can predict disease progression or treatment response.
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“From a public health and policy perspective, the study reinforces the importance of recognizing PTSD as a chronic medical condition with significant long-term health implications,” Luft said.
“Investing in early diagnosis, comprehensive treatment and long-term follow-up for trauma survivors, including our first responders and veterans, may improve quality of life while reducing the burden of chronic disease.”
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