Identifying hospital-at-home interventions in acute care: a national survey study in Denmark

An ageing population places an increased pressure on emergency departments, which prompts interest in Hospital at Home (HaH) models such as early supported discharge and admission avoidance. While these models may improve patient care and hospital capacity, systematic knowledge about their organization and implementation across countries remains limited. This study aimed to identify, describe, and compare the characteristics of cross-sectoral HaH interventions for acute medical patients in Denmark and discuss organizational strengths and challenges. A national survey was conducted among all 27 emergency and geriatric departments in Denmark (21 hospitals). Data were collected between 10 December 2024 and 02 May 2025 via a structured survey on intervention characteristics, sent to department leadership. Cluster analysis was applied, with each cluster representing an archetype model of HaH. Heat maps visualized characteristics across clusters. The survey achieved a 96% response rate, and 14 interventions were included. Cluster analysis identified four distinct models based on 66 characteristics: Immediate Discontinuation Model, Streamlined Model, Integrated Model, and Mobile Geriatric Model. These models reflect different approaches to hospital substitution and integration, shaped by variation in initiation, clinical responsibility, and inter-organizational collaboration, alongside shared tendencies such as limited GP involvement. HaH models for acute medical patients in Denmark vary in structure and cross-sectoral integration. These archetype models may support the development of context-sensitive HaH services in other healthcare systems.