The Hospital at Home (HDOM) programme is, in essence, a hospital without walls: it allows patients to receive the same treatment as in a hospital, but without leaving home.
Despite the good results, the model still faces significant challenges to continue growing and consolidating. Some are common to many health systems, while others are linked to societal transformation and the role of technology.
Caring for an increasingly fragile population
The first major challenge is the ageing of the population and the increase in chronic diseases. We are caring for increasing numbers of frail people who need a comprehensive approach, not just focused on a specific disease. Coordination with primary care, geriatrics teams, and social services is key to ensuring that the person can continue living at home safely and with support.
Incorporating new clinical areas
HDOM is no longer just used for common infections or conditions. Today, we also care for people after surgery, transplants, haematological procedures, and mental health disorders. The challenge is to adapt protocols, equipment and pathways to meet increasingly complex needs, without losing the safety that characterizes a hospital admission.
Technology as an ally
Another challenge is the incorporation of telemedicine and connected devices. Today, we can monitor blood pressure, oxygen, or even an electrocardiogram from home and send the information to the care team in real time. But this requires investment, training and, above all, ensuring that the technology is easy to use. Innovation must go hand in hand with humanization: it is not just a matter of having data, but of knowing how to interpret them and supporting the person.
Clinical safety at home
One fundamental aspect of HDOM is ensuring that care at home is as safe as it is inside the hospital. Rapid response protocols, access to complementary tests, and the availability of multidisciplinary teams ensure that any complication can be detected and resolved early. Data show that people admitted at home have a lower risk of hospital-acquired infections and experience the process with fewer interruptions and greater comfort.
The experience of patients and families
Patient and family satisfaction is extraordinarily high. At the Clínic we systematically evaluate the experience of patients and caregivers, and the result is an average Net Promoter Score (NPS) of 94 out of 100, a figure that is very rare in healthcare settings. Patients especially value the accessibility of the teams, the convenience of receiving care without leaving home, and being able to maintain their daily routines.
Looking ahead
Hospital at Home is one of the major initiatives for transforming the way we understand healthcare. It allows for the care of increasingly complex patients, the incorporation of new clinical areas, and makes it possible to do so without sacrificing safety or quality. The challenges are great, but so are the opportunities. A hospital without walls, flexible and accessible, is one of the keys to addressing the future of our health.
