Extending Hospital-at-Home to nursing homes
Findings from a novel care model in Singapore
Bibliographic Data
| ID | 22085510 |
|---|---|
| Authors | Chong Yau Ong (0000-0002-6230-7134, SingHealth Duke-NUS Academic Medical Centre, corresponding author), Angus Jun Jie Ng (Sengkang General Hospital), Hui Juan Ngo (Sengkang General Hospital), Eunice Jia Hwei Ya (Sengkang General Hospital), Jean Mui Hua Lee (SingHealth Duke-NUS Academic Medical Centre) |
| Year | 2025 |
| Volume | 13 |
| Pages | 1595535-1595535 |
| Publication date | 2025-07-24 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2025.1595535 |
| PMID | 40777635 |
| OpenAlex | W4412646771 |
| Language | EN |
| References cited | 31 |
Background We implemented a Hospital-at-Nursing Home (HaNH) pilot program in a nursing home to reduce acute hospital bed utilization and allow residents to receive right-sited care in familiar environments. Methods A prospective data collection of the Hospital-at-Home (HaH) program was conducted from November 2023 to December 2024 in a regional general hospital. Result 16 HaNH enrollments were completed, comprising three admission avoidance cases and thirteen early supported discharges. Pneumonia (56.3%) and urinary tract infections (18.8%) were the most common diagnoses. The median length of stay was three days (range 1–12, IQR 4). One mortality occurred within the program in the HaNH in alignment with the patient’s preferred place of care and death, supported by palliative care. Comparisons with a non-institutionalized HaH cohort ( n = 349) had a higher risk of escalation to the actual hospital facility (RR = 5.45, 95% CI: 1.71–17.42, p = 0.0025; aRR = 1.32, 95% CI: 0.35–4.96). HaNH patients had increased vulnerability, with higher post-discharge mortality (RR = 10.9, 95% CI: 2.16–55.21, p = 0.004; aRR = 3.38, 95% CI: 0.83–13.71) and emergency visits (RR = 3.18, 95% CI: 1.72–5.88, p = 0.0002; aRR = 2.00, 95% CI: 1.18–3.36), though readmission risk was non-significant. Conclusion These preliminary findings suggest that while HaNH may alleviate hospital bed shortages, patients in nursing homes are at increased risk of deterioration and require careful selection and support
Aspiration pneumonia · Confidence interval · Nursing homes · Pneumonia · Relative risk · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Palliative Care and End-of-Life Issues · Emergency Medicine · Internal Medicine
| Highly cited | No |
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