Hospital at Home
Geriatrics Models of Care
You may not have noticed it on the cover, but this report is number 250. Without delving too deeply into our history, it would be fair to say that KCE has covered an extremely broad range of topics, and that its conclusions and recommendations touch almost every health care and health insurance domain. And yet, this diversity does contain a number of constants which are directly applicable to the topic we are interested in today: hospital at home. First observation: when it comes to health care
... omes to health care reform, we must accept that there is no magic bullet. Like the other innovations we have examined during the course of our 250 studies, hospital at home is not the solution which will magically resolve all of the troubles faced by hospital care. A health care system must evolve using small steps, taken one at a time, and each must be deployed with great care following pilot studies in the field. A second major red thread runs through the majority of our endeavours: improvements in health care are impossible without improvements in quality. Quality itself demands professional excellence from physicians and other care providers, encompassing multidisciplinary vision, teamwork and sharing of information. Integration and continuity have become incontrovertible concepts. The same holds true for hospital at home, which will only prove useful if it adheres firmly to this approach. A third common thread -the last we will mention -among those often repeated during the past twelve years: awareness that the meaning of "patient" is irrevocably changing in the 21 st century. Shifting from "passive subject" to full partner and manager of his or her own health. This active role, sometimes taken on by informal caregivers, is an essential precondition for hospital at home to be successful. Does this study have anything new to share? Yes and no. Our researchers immerse themselves fully in each new topic, critically examining the literature, listening to actors in the field... and thus discover specific challenges and unexpected solutions each and every time. Once again, they have collected a series of questions that still require creative answers tailored to the local context. Thus, this report serves to roughly sketch the contours of experiments worth performing.