Can home-based treatment models make chronic kidney disease and heart failure care less hospital-centered?

Yes, home-based care can shift heart failure and kidney disease treatment away from hospitals, but it works best for select patients. Evidence shows home dialysis and hospital-at-home models cut costs and improve quality of life, though remote monitoring alone hasn't consistently reduced hospitalizations.

Direct answer

Yes, home-based treatment models can make chronic kidney disease and heart failure care less hospital-centered, but they're not a one-size-fits-all replacement. For example, home dialysis offers better quality of life and autonomy compared to in-center hemodialysis [4], and hospital-at-home programs can safely treat select worsening heart failure patients at home, reducing hospital admissions [2][5]. However, remote monitoring alone hasn't consistently cut hospitalizations—only tracking of congestion via implanted devices has shown clear benefit [3]. The evidence suggests these models work best for stable or moderately ill patients, not those needing intensive care.

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About These Sources

This answer is built on 5 peer-reviewed studies — published from 2022 to 2023, 5 in Q1 journals, collectively cited 222 times — selected as the most relevant from 8 studies that passed quality screening, drawn from 64 papers retrieved from a database of over 500 million.

Sources used in this answer

1

Analysis of Worsening Heart Failure Events in an Integrated Health Care System

The paper analyzes worsening heart failure events within an integrated health care system, examining the distribution of care across outpatient, ED, and hospital settings. It highlights the growing trend of reducing reliance on hospitalization, which relates to shifting away from hospital-centered care, but does not discuss home-based treatment models.

2

Hospital at Home as a Novel Care Strategy for Worsening Heart Failure

The paper evaluates the Hospital at Home model for worsening heart failure, highlighting its potential to improve patient outcomes by delivering inpatient-level care at home. It critiques traditional hospital-centered care and proposes a shift towards a more flexible, patient-centered approach, directly relating to the reduction of hospital-centric treatment.

3

Remote Monitoring for Heart Failure Management at Home

The paper focuses on remote monitoring for heart failure management at home, detailing telemonitoring techniques and their impact on reducing hospitalizations. It is relevant as it explores home-based treatment models and their potential to decrease reliance on hospital-centered care.

4

Home dialysis therapies

The paper examines home dialysis therapies and their benefits over in-centre haemodialysis. It highlights improvements in patient autonomy and quality of life, indicating a move away from traditional hospital-centered care for chronic kidney disease.

5

Hospital at Home as a Treatment Strategy for Worsening Heart Failure

The paper evaluates the hospital at home model for worsening heart failure, highlighting its potential to provide patient-centered care and reduce reliance on traditional inpatient settings. Its focus on alternative care delivery aligns with efforts to de-emphasize hospital-centered approaches in chronic disease management.