Hospital in the home – care where patients want it

By Alex Lynch

The expansion of hospital in the home (HITH) services is a fantastic opportunity to improve patient access to safe and effective care. Imagine being able to receive high-quality medical treatment in the comfort of your own home when your doctor feels it is appropriate. This is what HITH offers – high-acuity care at home, with medical supervision and treatment for acute illnesses or injuries, led by hospital-level medical staff.

Not only does this model provide excellent care, but it also supports ongoing recovery and functional capacity at home, reducing the need for long hospital stays and avoiding readmissions. It’s a win-win situation for both patients and the healthcare system.

Despite the clear benefits, HITH services are underutilised in Australia. In countries like the UK and US, a significant portion of bed capacity is dedicated to out of hospital (OOH) care (such as HITH). However, in Australia, OOH care accounts for only 5% of private hospital care, with HITH representing just a small fraction of that. This is where the need for Federal Government reform comes in.

Research shows that Australians overwhelmingly support patients and their doctors deciding on accessing HITH and sub-acute care, provided it is safe and appropriate. Yet, the absence of default benefits has limited the expansion of these services, allowing private health insurers to determine when and where a patient gets access to HITH. Insurers often hesitate to fund HITH services, choosing only to fund those services that suit their commercial interests. They’re also actively pursuing their own vertically integrated models (a US-style form of care delivering called managed care). This has created uncertainty and prevented hospitals from investing in HITH at scale.

Insurers have estimated that expanding OOH could save the private health system a whopping $1.3 billion annually. Contrary to some claims, clinician-led HITH services would not lead to higher health insurance premiums. Instead, they would enable more productive allocation of funding, driving down costs and ensuring patients receive appropriate care in the right setting.

The Health Minister, Mark Butler, recently announced a series of private health insurance policy proposals – including an expanded default benefit. This is a critical step in the journey to delivering expanded care for HITH in the private sector, particularly in regional Australia.

Adopting default benefit arrangements for OOH services, including HITH is essential for improving healthcare delivery and productivity in Australia. Failure to do so in the near term will represent a missed opportunity. It’s time for Federal reform to support these innovative care models, ensuring better health outcomes and greater efficiency in our healthcare system.

Listen to Alex’s interview with the The World Today on ABC Radio