ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1595535
This article is part of the Research TopicChallenges and Innovations in Healthcare Management and Long-Term Care for an Aging SocietyView all 19 articles
Extending Hospital-at-Home to Nursing Homes: Findings from A Novel Care Model in Singapore
Provisionally accepted
- 1Sengkang General Hospital, Singapore, Singapore
- 2Duke-NUS Medical School, Singapore, Singapore
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Background: We implemented a Hospital-at-Nursing Home (HaNH) pilot program in a nursing home to reduce acute hospital bed utilization and allow residents to receive right-sited care in familiar environments. Methods: A prospective data collection of the Hospital-at-Home (HaH) program was conducted from November 2023 to December 2024 in a regional general hospital. Result: 16 HaNH enrollments were completed, comprising three admission avoidance cases and thirteen early supported discharges. Pneumonia (56.3%) and urinary tract infections (18.8%) were the most common diagnoses. The median length of stay was three days (range 1-12, IQR 4). One mortality occurred within the program in the HaNH in alignment with the patient's preferred place of care and death, supported by palliative care. Comparisons with a non-institutionalized HaH cohort (n=349) had a higher risk of escalation to the actual hospital facility (RR=5.45, 95% CI: 1. p=0.0025; aRR=1.32,. HaNH patients had increased vulnerability, with higher post-discharge mortality (RR=10.9, 95% CI: 2.16-55.21, p=0.004; aRR=3.38, 95% CI: 0.83-13.71) and emergency visits (RR=3.18, 95% CI: 1.72-5.88, p=0.0002; aRR=2.00, 95% CI: 1.18-3.36), though readmission risk was non-significant. Conclusion: These preliminary findings suggest that while HaNH may alleviate hospital bed shortages, patients in nursing homes are at increased risk of deterioration and require careful selection and support.
Keywords: escalation, hospital-at-home, hospital-at-nursing home, hospital-in-the-nursing home, Length of Stay, nursing home
Received: 18 Mar 2025; Accepted: 11 Jul 2025.
Copyright: © 2025 Ong, Ng, Ngo, Ya and Lee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chong Yau Ong, Sengkang General Hospital, Singapore, Singapore
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