Hospital-at-Home in Taiwan: Reducing Hospital Stay and Medical Expenditures.

Abstract

Background: Hospital-at-Home (HaH) is an alternative care model that delivers hospital-level treatment at home, improving patient outcomes while reducing healthcare costs. Despite its success globally, HaH was not implemented in Taiwan until the initiation of a pilot program. This study evaluates the outcomes of HaH compared to traditional hospitalization.

Methods: A retrospective cohort study was conducted at a tertiary medical center in Taiwan. HaH patients diagnosed with pneumonia, urinary tract infection, or soft tissue infection between August 1, 2024, and January 31, 2025, were included (n = 69). A matched hospitalized cohort (n = 246) was selected based on age, sex, and diagnosis. Outcomes, including length of stay, medical expenditure, emergency department (ED) visits, rehospitalization, and patient satisfaction, were analyzed using univariate and logistic regression analyses.

Results: The HaH cohort had a significantly shorter length of stay (adjusted OR: 0.53, 95% CI: 0.30-0.93, p = 0.028) and lower medical expenditure (adjusted OR: 0.18, 95% CI: 0.10-0.33, p < 0.001). HaH patients were more likely to transition to home healthcare (73.9% vs 7.3%, p < 0.001), and satisfaction was 100%. No significant differences were found in ED visits or rehospitalization rates between the two cohorts (all p > 0.05).

Conclusion: HaH is an effective alternative to hospitalization, reducing length of stay and medical expenses while maintaining patient safety and satisfaction. Expanding HaH to additional conditions could further enhance healthcare efficiency. These findings highlight HaH's feasibility in Taiwan and its role in healthcare resilience.