Hospital in the home: a concept under question

Gideon A Caplan
Med J Aust 2006; 184 (12): . || doi: 10.5694/j.1326-5377.2006.tb00410.x
Published online: 19 June 2006

The debate on its efficacy has been reignited

Improvements in technology and greater acceptability have narrowed the gap between care in the hospital and care in the home. More patients with more diagnoses are receiving a greater diversity of hospital-type treatments at home than ever. However, the schism that once existed between hospital and home for treatment has opened up within the “hospital in the home” (HITH) movement over whether the concept works at all.

  • 1 Hospital in the Home, Post Acute Care Services, Prince of Wales Hospital, Sydney, NSW.
  • 2 School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW.


  • 1. Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalised patients: results of the Harvard Medical Practice Study II. N Engl J Med 1991; 324: 377-384.
  • 2. Larkins RG, Martin TJ, Johnston CI. The boundaryless hospital — a commentary. Aust N Z J Med 1995; 25: 169-170.
  • 3. Shepperd S, Iliffe S. Hospital at home versus in-patient hospital care [review]. Cochrane Database Syst Rev 2005; (3): CD000356.
  • 4. Shepperd S, Harwood D, Gray A, et al. Randomised controlled trial comparing hospital at home care with inpatient care. II: cost minimisation analysis. BMJ 1998; 316: 1791-1796.
  • 5. Caplan GA, Ward JA, Brennan N, et al. Hospital in the home: a randomised controlled trial. Med J Aust 1999; 170: 156-160. <MJA full text>
  • 6. Canet J, Raeder J, Rasmussen LS, et al. Cognitive dysfunction after minor surgery in the elderly. Acta Anaesthesiol Scand 2003; 47: 1204-1210.
  • 7. Leff B, Burton L, Mader SL, et al. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med 1997; 127: 989-995.
  • 8. Caplan GA, Coconis J, Sayers A, Board N. A randomised controlled trial of Rehabilitation of Elderly and Care at Home Or Usual Treatment (The REACH OUT Trial). Age Ageing 2006; 35: 60-65.
  • 9. Leff BA, Burton L, Burl J, et al. Return of physical function among patients eligible for home hospital treatment. The Johns Hopkins home hospital national demonstration and evaluation study. J Am Geriatr Soc 2003; 51 Suppl: S33.
  • 10. Caplan GA, Coconis J, Woods J. Effect of hospital in the home treatment on physical and cognitive function: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005; 60: 1035-1038.
  • 11. Board N, Brennan N, Caplan GA. A randomised controlled trial of the costs of hospital as compared with hospital in the home for acute medical patients. Aust N Z J Public Health 2000; 24: 305-311.


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