Hospitalization at home has many advantages for the patient, even if it requires some adaptation. Which treatments are affected? How to ensure their safety? We take stock, while this organization of care, a priori more comfortable and less stressful, tend to develop.
Some 81% of people would be in favor of hospitalization at home (HAD) if their doctor offered them, provided that the security conditions are met. At the same time, 49% fear to be a burden for their loved ones. It is not always easy to let the disease into your home with the visits of the nurse, the caregiver, the physiotherapist or a child nurse, sometimes several times a day. The family has to adapt. However, HAH is developing, including for children. The economic context is pushing in this direction, knowing that a day of hospitalization at home costs four times less than a conventional hospitalization.
Hospitalization at home has many advantages for the patient. But this care at home doctor bulk billed requires a constant investment from the family.
You have the right to refuse a HAH
The patient must give his consent, as well as his attending physician. Refusals are rare, most of them motivated by anxiety or the concern to preserve one’s home. An expert pediatrician insists on the need to prepare parents well when their premature baby is hospitalized at home. “They have to feel ready. If one of the parent’s objects to the return home, the child will remain in the hospital.”
Many treatments can be performed in HAH
More and more treatments can be carried out outside the hospital: post-surgical care, rehabilitation after a stroke, complex dressings (wounds, ulcers), antibiotic therapy, chemotherapy, care palliative, the monitoring of risk pregnancies and even the care of premature infants fed by tube. Also provided the child is stable on the respiratory and cardiac map.
A coordinating doctor orchestrates the care in conjunction with the general practitioner and the professionals who work at the bedside. But when the patient’s condition requires a significant technical platform or specialized examinations, hospitalization remains the only solution.
The attending physician may prescribe a HAH
You do not need to have been hospitalized to benefit from this organization of care. A general practitioner can, like a specialist or a hospital practitioner, prescribe a HAH. In 36% of cases, the attending physician takes the initiative.
Not all accommodations are suitable
The evaluation of the accommodation is carried out systematically to ensure that the patient will be treated in optimal conditions. It is indeed sometimes necessary to make extra room for a medical bed in your home or to allow the passage of a wheelchair for the comfort of the patient. Above all, you must be able to access it.
The patient or a loved one must be able to open the door or agree to entrust their keys,” explains a coordinating doctor.
It is also necessary to be able to store equipment, for example, for parenteral nutrition or antibiotic infusions.
Quality of care is the same as in hospital
All HAH structures are authorized by the Regional Health Agency on which they depend and meet the same specifications as hospitals. Each must provide several quality indicators.
You will have an interlocutor in case of emergency
A hotline is available seven days a week, 24 hours a day. At the end of the line, a nurse will alert a doctor for rapid decision-making and, depending on the severity, an intervention at home. Sometimes the problem can be solved remotely by the coordinating doctor, for example, by adjusting the prescription of painkillers.
You cannot change nurses
The HAH works with salaried professionals and liberals. Often, the patient already knows the liberal nurse, but he cannot intervene on the choice of salaried staff. As in the hospital, you do not choose the caregiver who comes to take care of you. However, it is always possible to discuss it with the referring doctor who will take care to find a solution.
You can be hospitalized if necessary
Return to the hospital is sometimes necessary. It occurs in 32% of cases, either because of the patient’s condition deteriorates, or to perform additional examinations.
The treatment is the same as in the hospital
Treatments are reimbursed in the same way as in the hospital. However, the HAH does not provide meals, shopping or laundry. People who need help at home must request other devices (mutual, personalized help for independence…).
There are significant regional disparities
HAD has progressed too slowly, but today the whole territory is covered. In principle, everyone can benefit from it, whether they live in town, in rural or mountainous areas. However, the appeal rate varies from region to region, depending on the organization and local initiatives.
An almost normal life
For people who benefit from HAH, this alternative to hospitalization is generally very well experienced. According to a study, 90% of patients would be satisfied with this model of care.
The medical team members (nursing assistants, nurses, psychologists, etc.) take turns with the patient and try to be discreet while participating in the life of each family.
More and more HAH requests
The HAH is aimed at all insured persons (the costs are generally reimbursed at 100% if you are on a “long-term illness”, or paid by the mutual insurance company), whatever their age. The areas of health supported by this type of structure are increasingly open (perinatal, orthopedics, oncology, geriatrics, psychiatry, etc.).
Difficult to obtain places
Alas, it is difficult to obtain a place in HAH. Why? Because not all geographic areas are yet covered by this system and these structures are mainly located in urban areas. The capacity, of around 4,500 places (public or private structure such as the Red Cross), is insufficient to meet all requests.
Home hospitalization: how does it work?
Admission to HAH is offered, following hospitalization, on medical prescription from the hospital doctor or the attending physician, if they believe that care can be continued at your home. This decision is taken in agreement with you and your family, and your home must be able to lend itself to medical requirements (store equipment and medicines, possibly receive a medical bed, etc.). It is your family doctor who will relay the treatment between you and the HAH.
Seven days a week and 24 hours a day
Finally, be aware that the home hospitalization service operates seven days a week and 24 hours a day. In other words, you can call the service at any time, and a nurse will answer your questions or come to your home.
Hospitalization at home requires a total investment from the family. It is necessary to know it and to be ready to assume the material and psychological efforts which that implies.
Since the nursing staff can intervene at any time at your home, it is difficult to maintain family intimacy.
Also be aware that in the event of disability of the suffering person, you are responsible for his safety, day and night. If you decide to hire someone to help you, you will be responsible for all costs.
It is also up to you to provide meals (sometimes with special diets depending on the treatments) and all household charges that may be added (linen, cleaning, etc.). Everyone’s investment must, therefore, be carefully discussed and not be underestimated.
Despite the investment required to support your loved one, the HAH provides a reassuring and secure environment for your parent.