References
Hospital in the Home service: an innovative model for managing patients outside of acute care beds
Abstract
The growing pressures on global healthcare systems, driven by an ageing population and increasing care complexity, necessitate innovative alternatives to traditional inpatient care. The ‘Hospital in the Home’ (HITH) model, offering acute-level care in patients' homes, is an emerging solution that has gained traction in both the UK and Australia. This article outlines the establishment and development of a HITH service within one of Australia's busiest tertiary referral hospitals, located in a socioeconomically deprived region in South Western Sydney. It examines how the service has evolved over time, significantly reducing hospital bed occupancy, managing diverse clinical conditions, and adapting to the specific needs of the local population. The analysis also offers insights into the challenges and future directions of the HITH model.
In many developed nations, healthcare systems are increasingly burdened by rising patient numbers, an ageing population, and technological advances in medicine. The demand for acute hospital beds often exceeds capacity, forcing healthcare providers to explore alternative models of care that offer comparable clinical outcomes while alleviating pressure on hospitals. The ‘Hospital in the Home’ (HITH) model has emerged as an innovative solution to address these challenges, delivering hospital-level care in the patient's home and substituting for inpatient admission.
The popularity of HITH is reflected globally, particularly in the UK, where initiatives such as ‘Hospital at Home’ have achieved measurable success. For example, a service in southwest London, launched in 2021, saved an estimated 2134 hospital bed days in its first year (Central London Community Healthcare NHS Trust, 2022). HITH offers an acute clinical service that delivers hospital-level care outside of traditional inpatient settings. However, it is crucial to distinguish HITH from ‘virtual wards’, which focus on remote monitoring of chronic conditions. HITH, by contrast, emphasises short-term, acute care at home (UK Hospital at Home Society, 2025). Although in the UK this excludes outpatient parenteral antimicrobial therapy (OPAT), which is typically managed by its own team (often staffed by infectious diseases specialists), in Australia the definition does in fact encompass OPAT due to variations in healthcare service provision.
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