Shanina Knighton discusses drawbacks of at-home care

At Home Care Stock Image

Hospital-at-home programs can offer significant advantages for both patients and health systems, including lower costs and better outcomes. However, there is a noticeable lack of discussion surrounding health equity issues associated with the care model, Shanina Knighton, PhD, RN, wrote in a Feb. 17 op-ed for Medpage Today.

Health systems' eligibility requirements — intended to determine which patients can safely receive at-home care — may favor certain patients, such as those with access to the internet,  according to Dr. Knighton, an associate professor of nursing at Cleveland-based Case Western Reserve University. 

In addition, all home environments deemed suitable for hospital-at-home are not necessarily equal, she added. Some patients may live in food deserts without access to nutritious meals to aid in their recovery. Others may live in unhygienic conditions that put them at risk for infections or other health issues, Dr. Knighton wrote.

She recommended hospitals offer hospital-at-home patients technology and meal services, among other actions, to address these equity concerns. The federal government and insurers should also subsidize internet and energy costs for hospital-at-home technology, she argued.

"The potential benefits of hospital-at-home are clear, but only if it can be implemented in a fair and equitable manner," she wrote. "This will necessitate filling at-home resource and education gaps, and conducting research to determine cost-effectiveness and outcomes."

Read the full editorial in Becker's Hospital Review or Medpage Today.