Hospital in the home

Hospital in the Home (HITH) is an important service that provides hospital-level care for patients in their home environment and may include RACFs. Services include intravenous therapy (mainly antibiotics), anticoagulation, wound care and chemotherapy for suitable patients in their own homes. HITH aids in preventing unnecessary and harmful hospital admissions by providing more timely and acute care in the home.¹

HITH should not be confused with transition care programs that help older people to transition from hospital to home after they have been discharged (refer to Part C: My Aged Care for further information on transition care programs).

The types of services that HITH provides differ across states and territories. For further information, see Table 1.

HITH is commonly used for the treatment of infections such as cellulitis, gastroenteritis, pyelonephritis, pneumonia, neutropenic and HIV-related disease, endocarditis, infected prostheses and osteomyelitis. Other conditions that can be managed at home include deep venous thrombosis, wounds, cystic fibrosis and hyperemesis.¹ The range of conditions being treated at home is increasing.

Typically, HITH is a 24-hour, seven-days-a-week service. Visits by a nurse are in place for business hours and after-hours, but medical staff are available at all hours by telephone.

Many communities in rural and remote Australia do not have easy access to health services. Outreach programs are important to increasing communities’ access to health service. In some instances, HITH services are provided as part of a GP service to increase access to care; however, this depends on the local health resources that can help support care.

Local PHN HealthPathways and local health networks are important repositories of information on the suite of clinical pathways and supportive local public and private referral options.

In some states/territories a GP can refer their patients directly to an HITH program without the need for them to go to hospital. Patients then undergo an assessment by the HITH team to ensure they meet the criteria to use the service.

If the patient is successfully enrolled in the program, the HITH team will then liaise with the GP as needed and keep them up to date once the patient has been discharged from the program. There is usually no requirement for a patient to visit their GP while being cared for by the HITH program.

Typically, patients are referred to HITH via the hospital. It is important that the HITH team communicate with a patient’s regular GP so the GP is aware their patient is receiving HITH treatment.