South African patients, who would normally be admitted to hospital for acute-level care, are choosing to have the same services in the comfort of their home, thanks to the hospital-at-home concept that not only cuts costs and inconvenience, but also speeds up the healing process.
Doctors and medical schemes say apart from being affordable and eliminating the inconvenience of going to hospital, it also expedites healing and reduces the risk of in-hospital infections. Using sophisticated remote monitoring technology, medics are able to track even the slightest change in patients’ health, reports TimesLIVE.
Discovery Health, which launched the hospital-at-home initiative in January, has seen significant growth in demand from patients and doctors since then, with more than 160 patients having been admitted to the programme, while Bonitas has funded 1 154 members.
A range of ancillary services is provided for patients, including home oxygen therapy, intravenous infusions, fluid management and advanced wound care.
Those eligible for admission are mostly patients who could be cared for in a general hospital ward. Some conditions funded by medical schemes so far are uncomplicated respiratory, gastrointestinal, urinary tract and skin infections, including those who’ve had surgery and qualify for early discharge.
Some patients with COVID-19, chronic heart failure, hypertension, diabetes pulmonary embolism, renal failure and strokes had also opted for home treatment. Once admitted, patients are looked after by dedicated clinical teams which include doctors, nurses and other healthcare practitioners like physiotherapists and psychologists.
Discovery Health CEO Ryan Noach said the programme provides attractive alternative care for medical and post-surgical conditions that would otherwise require hospital admission. “Importantly, the evidence shows outcomes are as good, if not better, than in the case of in-hospital care.”
While globally, hospital-at-home programmes have existed for several years, in the wake of COVID-19, many leading medical institutions across the world such as the Mayo Clinic, Cleveland Clinic and Brigham and Harvard University’s Women’s Hospital had revived the concept.
Although home-based care appealed traditionally to older patients, Dr Abongile Qamata, who leads the non-hospital alternatives programme for AfroCentric Group that administers about 17 medical schemes in SA, said: “We have seen a significant shift and greater adoption among the younger population in addition to the uptake among the elderly.”
Treatment in the home rather than at hospital saved costs by more than 40% for a single admission, adde Qamata. “It is worth noting that bricks and mortar, or hospital fees, and not healthcare professional fees, drive admission costs.”
Qamata attributed the popularity of the concept to the fact that it is funded from the hospital benefit and not day-to-day savings.
Bonitas head of operations Morgan Mkhatshwa said even with 24-hour professional care at home, the costs were far less.
“Hospital-at-home is up to three times more affordable. If an average hospital stay costs R45 000, the hospital-at-home costs are about R15 000.” It also reduced the length of stay by up to 40% and improved patient satisfaction.
Though Bonitas introduced the concept late in 2020 its popularity grew rapidly and more than 1 000 patients had used it, averting 770 hospital bed days.
Mkhatshwa said the home option was “indispensable and would play a key role” in the future of healthcare, given the cost of hospital care, shortages of beds and healthcare staff such as nurses.
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