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Background: Home hospital (HH) is hospital-level substitutive care delivered at home for acutely ill patients who would traditionally be cared for in the hospital. Despite HH programs operating successfully for years, and scientific evidence of similar or better outcomes compared to bricks and mortar care, HH outcomes in the US for respiratory disease have not been evaluated.Research Question: Do outcomes differ between patients admitted to HH with acute respiratory illness vs other acute general medical conditions?Study Design and Methods: Retrospective evaluation of prospectively collected data of patients admitted to HH (2017-21). We compared patients requiring admission with respiratory disease (asthma exacerbation (26%), acute exacerbation for COPD [AECOPD] (33%), and non-COVID-19 pneumonia [PNA] (41%)) to all other HH patients. During HH, patients received 2 nurse and 1 physician visit daily, intravenous medications, advanced respiratory therapies, and continuous heart and respiratory rate monitoring.Main Outcomes: acute and post-acute utilization and safety.Results: We analyzed 1,031 patients; 24% were admitted for respiratory disease. Patients with and without respiratory disease were similar: mean age 68 (SD, 17), 62% female, and 48% White. Respiratory patients were more often active smokers (21% vs 9%; p<0.001). FEV1/FVC ≤70 in 80% of cases; 28% had severe or very severe obstructive pattern (n=118). During HH, respiratory patients had less utilization: length of stay (mean days, 3.4 vs 4.6), laboratory orders (median, 0 vs 2), intravenous medication (43% vs 73%) and specialist consultation (2% vs 7%) (p all <0.001). 96% of patients completed the full admission at home with no mortality in the respiratory group. Within 30-days of discharge, both groups had similar readmission, ED presentation and mortality rates.Interpretation: HH is as safe and effective for patients with acute respiratory disease as for those with other acute general medical conditions. If scaled, it can generate significant high-value capacity for health systems and communities, with opportunities to advance the complexity of care delivered. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Hospital at home (HaH) delivers hospital‐level care to acutely ill patients at home as a substitute for brick‐and‐mortar hospital care. The clinician and program characteristics of HaH programs worldwide are relatively unknown. We sought to describe the world's HaH clinicians and their programs' characteristics.We analyzed a survey administered to all attendees of the 2023 World Hospital at Home Congress. Clinician characteristics included age, years worked in HaH, profession, burnout, and experience. Program characteristics included location, daily census, types of care delivery, and clinical capabilities.Of 670 attendees, about 305 were clinicians and 129 responded (42% response rate for clinicians). The majority of clinicians were 30–49 years old (65.1%), new to the field (70.5% worked less than 10 years), and part‐time (18% dedicated >74% effort to HaH). Clinicians reported overall satisfaction with their job and low burnout. About half of programs were in Europe (52.1%), newly operational (44.7% less than 5 years), mostly operated in urban environments (87.2%), and mostly had a daily census of less than 25 patients (62.8%). Most programs operated 7‐days per week (88.3%), performed intermittent or continuous remote monitoring (81.4%), used video communication (63.8%), and had some advanced capabilities such as in‐home imaging (47.9%) and advanced procedures (23.4%). Visit frequencies to the patient's home were variable: most programs had physicians visit the home, nearly all had nurses visit the home, and fewer performed virtual visits.HaH clinicians and programs have significant similarities but also a fair number of divergent practices, much like brick‐and‐mortar hospital care. Further standardization of the care model will help to unify the field across the globe. [ABSTRACT FROM AUTHOR]