Objective:

To explore strategies for developing Hospital-at-Home (HaH) programs in Canada amidst increasing health system pressures.

Approach:

• Background: The article discusses the challenges faced by global health systems, particularly in Canada, due to overcrowding, limited hospital beds, and increased healthcare costs exacerbated by the COVID-19 pandemic.
• HaH Model Overview: Hospital-at-Home models provide hospital-level care in patients' homes, combining in-person visits and remote monitoring, and have been adopted in various countries.
• Evidence Review: The literature on HaH is concentrated in the US and UK, with limited Canadian studies, highlighting the need for country-specific data to guide implementation.

Key Findings:

• HaH programs can reduce system-level burdens on hospitals and improve patient outcomes.
• Most HaH models follow an extended nursing care approach with daily home visits.
• International evidence supports the effectiveness and safety of HaH, but is predominantly from the US and UK.

Interpretation:

The implementation of HaH in Canada requires consideration of its unique health system structure, which differs from those of the US and UK.

Limitations:

• The existing literature on HaH is limited in Canada, with a lack of comprehensive studies reflecting local healthcare dynamics.
• Most evidence is derived from health systems with different funding and operational frameworks.

Conclusion:

Tailored strategies are essential for the successful implementation of HaH programs in Canada, taking into account local health policies and infrastructure.

Sources:

• Canadian Institute for Health Information
• JAMA Network Open
• BMJ Open