Telemedicine-managed, physician-supervised at-home care results in better outcomes for acutely ill patients than a hospital stay, according to a major retrospective study conducted by BEYOND, the virtual hospital of Israel’s largest medical center, Sheba Medical Center.

The study, published in the PLOS One journal, is the first to demonstrate that hospital-at-home (HAH) care for patients with acute illnesses can offer a viable alternative to in-hospital stays.

The study involved 636 patients, including 159 who received HAH care and 477 who received care in the hospital. Some of the patients had Covid-19 while the others had acute urinary tract infections, pneumonia or cellulitis.

The study found that the median length of hospital stay was two days shorter in the HAH cohort for both Covid and non-Covid patients. Readmission rates within 30 days were not significantly different for all patients and remained insignificant within one year.

Furthermore, the risk of death within 30 days was significantly lower among the HAH cohort for both Covid and non-Covid patients.

“The Covid-19 pandemic demonstrated two long-term challenges for acute care – insufficient beds and space in hospitals to treat all of the acute patients, and a shortage of internal medicine specialists to treat patients. When confronted with these challenges we decided to seek out a viable alternative to in-hospital stay,” said study leader Prof. Gad Segal, head of the Sheba Education Authority.

Superior to hospital stays

“This is the first study to show that telemedicine-managed, physician-supervised hospital-at-home care is not inferior but even superior to in-hospital stays, presenting a major step forward for hospitals and health systems across the world.”

Patients in the HAH cohort treated through Sheba BEYOND received a minimum of one remote visit by an internal medicine specialist, two home visits from nurses and an individualized treatment plan consisting of imaging, blood testing and IV and oral treatment using cutting-edge remote care technology validated in numerous clinical studies.

“This research underscores the transformative potential of hospital-at-home care,” said Dr. Galia Barkai, director of Sheba BEYOND.

“We were able to demonstrate a significant reduction in mortality rates compared to traditional hospitalization. These groundbreaking results not only reinforce our commitment to delivering top-tier medical care in the comfort of patients’ homes but also mark a pivotal step toward achieving Sheba BEYOND’s vision of revolutionizing home-based care.”

Segal and his research collaborators, including Sheba physicians and Noa Zychlinski, professor of data and decision science at the Technion-Israel Institute of Technology, are now studying 140 patients to test the methodology examined in this research, comparing HAH to in-hospital stay acute illness patients.

“I believe we will find the same results in the prospective study, adding further evidence to this new methodology as a viable alternative to in-hospital acute care,” said Segal.