Overloaded Hospitals Ask COVID-19 Patients With Milder Symptoms To Get Home Treatment
ARI SHAPIRO, HOST:
Across the U.S., dozens of hospitals are now overloaded from high numbers of coronavirus patients, so some hospitals are sending people home and caring for them there instead. It could do a lot to ease crowding, and patients seem to like it. Colorado Public Radio's Andrea Dukakis reports from Denver.
ANDREA DUKAKIS, BYLINE: Late last month, with COVID-19 filling up hospital beds, the government health programs Medicare and Medicaid agreed to start paying for so-called hospital-at-home care. It's too early to tell how many hospitals are trying it, but some patients say it's far better than being in a hospital.
SUSAN SARCHET: Somebody is waking you up all night long.
DUKAKIS: Susan Sarchet lives in a small, tidy apartment in Denver. She's typically attached to an oxygen tank with a clear plastic tube trailing behind her. Sarchet has been in and out of the hospital a lot for a lung disease known as COPD.
SARCHET: I would have to have breathing treatments - like, three or four during the night. Somebody else came to take my blood. You really don't rest.
DUKAKIS: During her last hospital stay, she never could seem to figure out who was treating her.
SARCHET: Seven days in the last one in the ICU, and I never saw the same person twice.
DUKAKIS: When Sarchet, who's 80, got sick again, she really didn't want to go back to the hospital. Her Medicaid plan offered her a spot in a hospital-at-home pilot program run by a Denver-based company. Right away, health care workers showed up at her door with two cases of equipment, X-rayed her lungs and did a battery of tests.
SARCHET: All of a sudden, they were talking, well, she needs IV medication. Well, they improvised by moving a lamp into my bedroom and hanging the IV from there.
DUKAKIS: This isn't a typical home visit from a nurse or a house call made by a doctor. An entire team is responsible for care 24/7, though they're not on-site the whole time. And unlike hospitals, which now restrict visits, patients can have family at their homes. Johns Hopkins University professor Dr. Bruce Leff was an early adopter when he was a resident making house calls. His mostly older patients with chronic conditions would sometimes need hospitalization, but often they didn't want to go. He remembers one patient.
BRUCE LEFF: And he kind of looked at us like we were a little bit crazy. And he said, you know, I am so sick and tired of you geniuses from Hopkins. You're great doctors, but you run a crappy hotel, and I'm not going to a hospital.
DUKAKIS: In the 1990s, Leff and his colleagues started experimenting with treating people with even more serious conditions at home. Most had a history of being in and out of the hospital.
LEFF: People liked it. The outcomes were terrific, and then the costs were lower.
DUKAKIS: Twenty years since then, research has shown the same thing. But many hospitals lack the motivation to adopt it until now. Before the pandemic, some had empty beds they wanted to fill. Susan Diamond is with Humana, the health insurance company. She says they're now moving forward with a hospital-at-home model.
SUSAN DIAMOND: I really think that in the absence of COVID, it probably would have taken three or more years to reach the level of interest in adoption that we're likely to see in 2021.
DUKAKIS: Diamond says along with virtual doctor's visits, it's another example of COVID-19 accelerating medical innovation. And with Medicare and Medicaid now saying they'll pay, more private insurance companies are expected to follow. For NPR News, I'm Andrea Dukakis in Denver.
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