Hospital at Home Versus Inpatient Care: Costs and Effectiveness

NCT07274072 | Recruiting

• 1 other identifier: 2025-00482
• Study Type: observational
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

Background and Objectives Hospital at Home (HaH) delivers hospital-level treatment to acutely ill patients in their own homes, including daily medical and nursing visits, infusions, physiotherapy, and diagnostics. It bridges inpatient and outpatient care, working closely with hospitals, office-based physicians, home care services (Spitex), and therapy providers. There are two main pathways: Admission Avoidance: stable patients requiring hospitalization are admitted directly to HaH instead of an inpatient ward. Early Supported Discharge: patients treated in hospital are discharged earlier than usual and transferred to HaH. Evidence International studies show HaH to be safe and effective. Reviews report comparable mortality and rehospitalization, shorter hospital stays, and cost advantages. Admission avoidance is linked to trends toward lower mortality and costs. Research showed similar mortality but fewer rehospitalizations, longer treatment duration, and reduced risks of institutionalization, depression, and anxiety. HaH patients were older, with reduced daily living activities, yet care costs were on average USD 5,054 lower than inpatient care. In Switzerland, the mean hospital stay in 2019 was 8 days (acute somatic: 5.2; psychiatry: 33.5). Study Hypotheses HaH can be delivered at equal or lower cost than regular hospitalization. HaH care is safe, with few complications, and yields high patient satisfaction. Study Objective To demonstrate that hospital-equivalent home treatment of acutely ill patients is effective, appropriate, cost-efficient (according to Swiss WZW criteria), safe, and associated with high satisfaction and low complication rates compared with inpatient care. Endpoints Primary: Costs - HaH vs. inpatient care at Hirslanden Clinic, using REKOLE® cost accounting. Secondary: Mortality, therapy type, monitoring, diagnostics, rehospitalization, complications, satisfaction, patient-reported outcomes, length of stay, referrals to nursing homes, follow-up after discharge, ED visits, rehabilitation referrals, and home care type.

Conditions

Costs and Cost Analysis; Effectiveness; Patient Satisfaction

Keywords

hospital at home; costs; clinical outcome; patient satisfaction

Outcome Measures

Primary Outcomes (1)

• Costs

  Comparison of cost of treatment in Hospital at Home vs. regular hospital ("brick and mortar"). Data will be collected via financal data of both groups, 100 patients from the regular hospital (Klinik Hirslanden Zurich) and 100 patients from Hospital at Home AG (Zollikon)

  1 year or until the total of 200 participants are included

Secondary Outcomes (3)

• Effectiveness (clinical outcome)

  1 year or until the total of 200 participants are included

• Effectivness (complications)

  1 year or until the total of 200 participants are included

• Patient satisfaction

  1 year or until the total of 200 participants are included

Other Outcomes (3)

• patient data

  1 year or until the total of 200 participants are included

• result of first blood sample

  1 year or until the total of 200 participants are included

• first vital signs measured at admission

  1 year or until the total of 200 participants are included

Study Arms (2)

Hospital at Home Group

100 participants treated in hospital at home

Regular hospital group/"Brick and mortar group"

100 participants treated in the hospital

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

200 participants total, 100 from the regular hospital ("brick and mortar"), 100 from Hospital at Home. Patients from 18years of age upwards with a disease treated in the hospital or in hospital at home.

You may qualify if:

• Inpatients in the hospital or patients in Hospital at Home care
• Age ≥ 18 years
• Admission due to a typical Hospital at Home diagnosis (mild to moderate inflammatory and infectious diseases of the lungs, urinary tract, gastrointestinal tract, heart, and skin; exacerbated chronic obstructive pulmonary disease; exacerbation of chronic heart failure; wounds; bleeding/anemia; dehydration; deterioration of general condition in multimorbid patients; infection-related complications in oncological patients; psychiatric problems including delirium; metabolic or autoimmune diseases; orthopedic patients; pain exacerbations of any cause; palliative patients up to and including terminal situations)
• Patients without severe cognitive impairment or dysfunction who are capable of providing informed consent and/or completing the questionnaire
• Patients with sufficient proficiency in written and spoken German and/or English

You may not qualify if:

• Inpatient admission for other reasons
• Refusal to provide informed consent

Sponsors & Collaborators

• Hospital at Home AG: lead
• Klinik Hirslanden, Zurich: collaborator

Study Sites (1)

Hospital at Home AG

Zollikon, Canton of Zurich, 8702, Switzerland

RECRUITING

Related Publications (1)

• Leong MQ, Lim CW, Lai YF. Comparison of Hospital-at-Home models: a systematic review of reviews. BMJ Open. 2021 Jan 29;11(1):e043285. doi: 10.1136/bmjopen-2020-043285.

  PMID: 33514582 RESULT

MeSH Terms

Conditions

Patient Satisfaction

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior

Central Study Contacts

Kilian Braendle, Dr. med.

CONTACT

+41444553304; kilian.braendle@hospitalathome.ch

Natascha Furrer, Coordinator

CONTACT

+41443553300; natascha.furrer@hospitalathome.ch

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 22, 2025
• First Posted: December 10, 2025
• Study Start: September 1, 2025
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: December 10, 2025

Record last verified: 2025-12

Locations

CH (1)