In recent decades the trend of home hospitalization has been expanding all over the world. In Israel, too, the trend has been developing in recent years, and already today medical services are offered in various fields provided to patients at home. More than a year after the outbreak of the corona, the public understanding, as part of dealing with the corona virus, is that the field of home hospitalization is the most natural and appropriate place to treat a wide range of diseases and medical conditions is the patient’s home.
Home hospitalization allows the patient to receive professional medical service in his natural environment – the home. Clalit Health Services realized years ago the need to transfer a certain percentage of patients to home hospitalization, due to all the significant benefits that there is to treating the home environment as an alternative to hospitalization.
“A complete, effective and safe alternative to hospitalization in an inpatient ward in a hospital”
“The future of medicine is in the community,” he says Erez Levy. Director of the Central District of Clalit. “We believe that most treatments should be in the community, in the patient’s natural environment, with the support of his family and loved ones. Clalit was the pioneer to understand this and also implement in the field. Acute home hospitalization allows patients to be hospitalized at home and receive quality medical care.
At the same time, we take care to equip patients with the best technologies so that we can be monitored remotely. “We are witnessing a steady increase in demand for this service, partly due to the corona plague that forced the health system to adapt to a new reality, while reducing risks and unnecessary exposure to infections and diseases for patients.
“In recent years the home has occupied an increasingly significant place as a therapeutic space,” he says Dr. Eyal Jacobson, Medical Director of the Dan-Petah District in Clalit. “The corona plague has accelerated these processes, both because of the congestion in hospitals and because of the fear of patients getting to hospitals and being exposed to infections and diseases.
The acute home hospitalization service of the Dan-Petah Tikva district in Clalit, in collaboration with Zabar Refuah, is an excellent example.
Thus, for example, a patient who is referred to a family doctor who diagnoses pneumonia that requires antibiotic treatment and daily medical follow-up, can refer him to an acute home hospital (acute) instead of referring him to the hospital. Sabar Refuah’s home hospitalization team will enter the patient’s home within four hours, assess his condition and build an appropriate treatment and follow-up plan. “
Dr. Itamar Ofer, President and Chairman of Sabar Medicine Providing the acute home hospitalization service for Clalit, adds that medical visits and home care are a solution for many patients, who prefer to receive home care, and especially for frail or confined patients, for whom hospitalization poses a risk of further health deterioration.
“It’s not only that it’s more comfortable and relaxed. It’s mostly safer. The nurse and the doctor come to the patient’s house every day and the hospitalization summary goes directly to the general practitioner’s computer. This ensures that the therapeutic sequence is maintained.”
“A completely different experience”
Tamar’s mother-in-law, who lives in Kiryat Ono (a long way from his family), suffered from acute pneumonia. “For a 76-year-old person with heart disease, pacemaker, pneumonia is a real risk,” says Tamar. “We really did not want to hospitalize him because for him it involves a lot of risk. Once we were generally told he could get hospitalized in his house, it was a very big relief.
Within hours a team of medical clerks arrived at his home, and we all felt that was exactly what he needed. They were available for him and for us all the time. I saw how calm and relaxed my father-in-law was. He really appreciated it and was very meaningful and good for it, “she notes.” It’s a completely different treatment experience. It has a lot of benefits for both the patient and the family. “
Patricia Zimmerman, who was recently appointed head nurse and head of Clalit Hospital Nursing, Used so far As the director of nursing and the director of the home hospitalization unit of the Sharon-Shomron district in Clalit, Where she took a significant part in leading the acute home hospitalization service. “As the district director of nursing, I was proud to take part in leading this revolutionary service, provided by the staff of the home care unit, and enabling Clalit’s insured persons to enjoy quality professional care in the comfort of their own home.”
“Acute hospitalization at home is the next required step in the health care system,” he says Mofid Qadan – Director of the Shaked Unit in the Sharon-Shomron District of Clalit. “Especially in light of the corona epidemic. Home hospitalization provided by Clalit Health Services is a groundbreaking service that allows policyholders to receive full medical care in their home and avoid hospitalization. There are huge benefits to hospitalization at home, for the patient and his family and also for the system – reducing infections, reducing deterioration and falls, great convenience for the patient and his family, and relieving the burden on community clinics and hospitals. “
“For us, the feeling was of rescue, no less”
Ronen Nodelman, Director of the Haifa and Western Galilee District at Clalit, “Today in modern medicine the attempt is to copy the treatments to the community and minimize the number of visits to the hospitals, in order to avoid the fear of exposure to infections, as well as unnecessarily disrupting the daily routine of the accompanying family members.”
“We strongly believe in copying most of the treatments to the community as medically as possible,” Nodelman emphasizes. “This is in line with trends in the world of modern medicine. So we also decided to expand the acute home hospitalizations – in addition to the prolonged home hospitalizations and home hospice that we run for decades as part of the unit for further treatment. Patients, the inpatient service at home has additional importance.
Even before Corona we started implementing the service, in collaboration with Zabar Medicine, I am glad that we had a service infrastructure, so that it could be expanded quickly and in accordance with the new need for home care instead of hospital – to reduce risks to patients and even ease hospital congestion. “
Jada Mahul, 56, from the village of Makr-Jadeida in the north, contracted the infection during her work as a nurse at Clalit. “I did tests and realized I had an infection and I needed to get intravenous antibiotics, and my husband contracted it from me. We were very afraid to be hospitalized both because we were afraid of infections in a hospital and also because there was no one left to care for children. One of the brothers working with me To the hospital.
Of course I called immediately to ask for a referral and in general they confirmed me immediately, “she notes. Jada says that the same day a team of nurse and medical doctor came to her and started monitoring, testing and monitoring, as she would receive at the hospital.” For us the feeling was rescue, no less . In our bed, with the family and the peace of mind that we are not cut off from the children, that is the best thing we could all have. “
Maintain the quality of life and health of the insured
“The main goal of acute hospitalization at home is to prevent hospitalization complications such as acquired infections, while maintaining the quality and safety of patients,” explains Dr. Maya Rosen, Medical Director of Clalit’s Central District. “Diseases such as pneumonia, urinary tract skin infections, dehydration treatment and other conditions that would have required hospitalization in the past are now being treated in the community. This is a daily visit and sometimes several times a day while monitoring and remote monitoring by a nurse doctor, laboratory tests, and more. This is undoubtedly the future of the health care system with the emphasis on home care and within the community. “
Ruth Baruch, Clalit’s Nursing Director in the Haifa and Western Galilee District, Which coordinates the issue of home hospitalizations in the district, notes that cases where the patient needs to receive intravenous treatment do not necessarily require hospitalization in an inpatient ward at the hospital. “The service includes installing transfusions to provide intravenous medication. If an examination is required that requires leaving the house, such as a lung scan, the patient is transported for examination and back home. Most patients have so far been discharged after about 5 days of hospitalization.”
“The service is provided with general funding, by a skilled professional team,” says Mofid Qadan. “We at Clalit’s Sharon Shomron District are proud of our ability to provide this service to our insured. The patient receives all services at home, in a comfortable and safe environment as a complete alternative to hospitalization in the hospital’s internal ward. Their loved one is in good hands.
“Patients who are suitable for acute hospitalization in their home are located by the family doctor or from the hospital. If the patient is suitable and approved for home hospitalization, he returns home and within a few hours the medical staff arrives for an admission visit and begins treatment.”
A quality and effective solution for the elderly
“The rate of aging in the State of Israel is one of the highest in the world,” she explains Enochashvili Wedding, Nursing Director in the Central District of Clalit“With the increase in age, the consumption of medical services also increases. In acute situations that require intensive care at home, we provide a medical and nursing solution, including several treatments a day. .
“In the past year, we have treated more than 200 patients in the Sharon-Shomron district in the home, with the average acute hospitalization in the home being about 5 days,” specifies Mofid Qadan. “All patients and their families are satisfied with the treatment and service, and in the past year we have expanded the service in the hope of doubling the number of patients who will be treated in their natural environment as an alternative to hospitalization.”
“All in all,” adds Dr. Itamar Ofer, “the public already understands that anyone who does not have to be in a hospital should not be hospitalized there. Therefore their clear preference is hospitalization at home. At the same time, health policy makers in Israel also understand that the point of view is no longer dichotomous, and home hospitalization makes it possible to alleviate the congestion in hospitals, especially looking to the future in terms of population growth and aging. “