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When to Seek Home Care

26 December 2023

Home Hospitalization is hospitalization under a medical observation in the patient’s home, rather than in a medical institute. It is appropriate for patients who are anticipated to be hospitalized for up to seven days and do not require respiratory or other vital sign monitoring.

Hospitalization at home provides a more positive experience for many patients, increasing their chances for an improved medical condition.

The service is provided by a doctor and a nurse, who arrive at the patient’s home a few hours after being transferred to home hospitalization.

Home care is a type of hospitalization that takes place in the comfort of the patient's own home as opposed to a medical facility, under the close supervision of a physician and a nurse.

Home care has been shown to be an effective and vital alternative that may increase patients' chances of recovery since it offers a more comfortable and satisfying experience for a large number of patients.

In 2022, the Ministry of Health has published a circular of the Medical Division: Criteria for hospitalization alternative at home for patients with acute diseases (Hebrew). According to the circular, the office has established that the HMOs should offer a hospitalization alternative at home for patients with acute medical conditions when their case is appropriate, and when there is a community medical system, capable of offering top quality healthcare and providing patients with an uncompromising safety framework that can instantly identify a clinical aggravation requiring evacuation to the hospital.

Benefits of home care

Hospitalization in a hospital may be accompanied by emotional and social difficulties, because of the unfamiliar hospital environment, away from the convenient and beloved home, and occasionally with no privacy (hospitalization in a shared room). Home hospitalization may decrease difficulties and increase the chances of an optimal improvement in the patient’s medical condition.

Moreover, Home hospitalization is a substantial advantage in terms of avoiding risks which particularly characterize the older adults population, for instance, cross-contamination, function decline, and confusion.

While patients benefit from the advantages of home hospitalization, so does the Health Care System, which suffers from a substantial overcrowding of the internal wards, because home hospitalization allows for a relief in terms of load, as well as a reduction in economic resources required for each patient, compared to institutional hospitalization.

How does home care work?

Confirmation of the insuring HMO: the family doctor on behalf of the HMO, the emergency room, or the internal ward at the hospital, will recommend a transfer to home hospitalization according to the criteria defined and detailed below; then the application will be sent to the insuring HMO for confirmation.

The service included in the home hospitalization will be provided by a doctor and a nurse who arrive at the patient’s home shortly after his arrivel home, and no later than four hours after being transferred from the hospital to home hospitalization.

Length of home hospitalization: home hospitalization is intended for patients who are anticipated to be hospitalized for up to seven days. However, in practice, home patients are hospitalized for a week or more, according to developments, and according to the recommendations of the medical teams, and the HMO’s confirmation.

Is home care right for me?

Who might benefit from home care?

  • Patients who according to medical estimations are anticipated to be discharged from hospitalization after seven days, at the most.
  • Patients suffering from pneumonia (provided they have been infected in the community); patients suffering from a simple urinary tract infection, a simple soft tissue infection, or an infection of the digestive system, may, in most cases, start or continue treatment in home hospitalization.
  • Patients who require isolation in a hospital setting due to a medical condition, such as immune-suppression or being a carrier of resistant bacteria.
  • Patients who do not require continuous monitoring and are stable in terms of respiratory and other vital indicators, such as blood pressure and pulse.
  • Patients suffering from a deterioration of a chronic disease, who require monitoring and high availability but are not in immediate mortal danger, for example, exacerbation of chronic obstructive pulmonary disease, exacerbation of heart failure or renal failure, treatment for diabetes complications and exacerbation of liver failure.
  • Patients suffering from a flare-up of chronic diseases like inflammatory bowel disease, arthritis, or psoriasis.
  • Home hospitalization may be suitable, in some cases, for patients with dementia.

Who might not benefit from home care?

  • Patients with a new condition of clouded consciousness, delirium, respiratory or blood pressure imbalance.
  • Patients suffering from a psychiatric condition that may endanger them, such as acute psychosis or fear of suicidality.
  • Patients whose results of clinical examination, laboratory tests and imaging screening indicate that they did not respond to treatment provided in the emergency room or during hospitalization.
  • Patients suffering from an acute illness and an assessment has been made of a substantial chance of an exacerbation in their medical condition, such as patients suffering from acute coronary heart disease or acute renal failure.
  • Patients who live alone and lack a continuous and close family support, including homeless people, solitary people, and migrant workers.
  • Patients and their caregivers, who lack sufficient cognitive and technical skills for activating the equipment required for home hospitalization and use of remote communication.

Home care funding

Home hospitalization services are provided directly through dedicated teams in the HMOs and by companies operating under agreements with the HMOs.

Home hospitalizations are included, at present, in the National Health Basket. Home hospitalizations confirmed by the HMOs are fully funded by them.

In some cases, home hospitalization which includes artificial respiration at home, including patients who require a connection to a B-Pap device, is also included in the National Health Basket.

As part of the home hospitalization services there is also a hospice service for patients suffering from an advanced incurable disease, including patients who suffer from an advanced dementia, and need palliative care.