The Response of Hospital at Home Services During the Covid-19 Pandemic: A Scoping Review

The aim of this scoping review was to examine the national and international literature on the response of adult Hospital at Home (HAH) services to the global Covid-19 pandemic and explore key themes to emerge and make recommendations for further research. The databases were searched using agreed search terms and Arksey and O’Malley’s scoping review framework was utilized and papers were identified and analyzed for common themes. Thirty-one papers were included in the review. Of the papers included, general adult medicine was the largest service group (n = 15) with geriatric services the next largest (n = 12). Most papers were European in origin (n = 19). Key themes to emerge include (1) similar outcomes for HAH patients compared with traditional inpatient care, (2) expansion of capacity for inpatient care due to HAH use, (3) growth of virtual monitoring in HAH setting, (4) reduction in infection transmission in HAH setting, and (5) cost reduction due to HAH utilization. Hospital at home demonstrated good outcomes for both patients with Covid-19 and other conditions during the pandemic. These services also expanded capacity during a global healthcare crisis. Remote monitoring played a major role in the expansion of capacity and the reduction of infection transmission during the pandemic. Although some papers discuss how HAH is more cost effective than traditional hospital, more work is needed around this as many of the patients may not have been as sick as those admitted to traditional hospital during the pandemic.