Hospital at home for the acute care of patients with liver disease: a clinical review

This is the authors' abstract. We don't add key points for this paper.

Patients with liver disease experience frequent hospitalizations for complications such as hepatic encephalopathy, ascites, infections, and gastrointestinal bleeding, resulting in substantial healthcare utilization and reduced time spent at home. Hospital at Home (HaH) is an increasingly utilized care model that delivers hospital-level acute care in the patient’s home through multidisciplinary care teams, remote monitoring, and home-based diagnostic and therapeutic services. This review summarizes the rationale for considering HaH in liver disease and outlines key program components. We review the existing evidence supporting HaH, including the limited hepatology-specific literature as well as broader data from randomized trials and systematic reviews in related populations. We show early studies in patients with cirrhosis suggest that HaH is feasible and safe in appropriately selected individuals. Furthermore, the broader studies comparing HaH to traditional care have consistently demonstrated comparable or improved clinical and patient-centered outcomes such as mortality, readmission rates, cost of care, patient experience, and caregiver burden. HaH represents a promising patient-centered addition to the continuum of acute care for individuals with advanced liver disease. Broader implementation in hepatology will depend on establishing evidence-based patient selection frameworks, defining disease-specific models of care, and carefully designed studies to better understand the impact of HaH on clinical outcomes, healthcare utilization, equity in access to care as well as patient-reported and caregiver outcomes.