Background: The Veterans Affairs (VA) Hospital in Home (HiH) model provides inpatient-level care at home for acutely ill Veterans. While peer-reviewed studies have demonstrated the benefits of such programs, more data is needed to demonstrate the safety and efficacy of these programs to justify adoption (1-7).
Methods: We evaluated 30‐day heart failure (HF) readmission rates, inpatient bed‐days in the 6 months before and after HiH admission, program costs, patient satisfaction, and the number of medication errors identified and rectified by the HiH team in 2025. Data were drawn from VASD’s Managerial Cost Accounting reports, the Corporate Data Warehouse, and post‐discharge patient surveys.
Results: The HiH program cared for 84 patients in 2025. Average patient age was 74, with Care Assessment Needs (CAN) scores averaging 96. Readmission rates at 30 days was 14% for heart failure patients discharged to HiH compared to 19% for those discharged from VASD to home or facility. Heart failure patients admitted to HiH spent 37% fewer days inpatient in the 6 months after HiH admission compared to the 6 months before HiH admission. Cost per bed day was 89% lower on the HiH service compared to an inpatient bed-day, and total episode cost was 33% lower. Patient satisfaction was universally positive, with 100% of surveyed Veterans recommending the program (n=38). Medication errors were tracked starting in July of 2025. Eighteen of the 22 patients (81%) who were formally tracked for medication errors were found to have at least one medication error. Errors in taking the incorrect dose and medication omissions (patients taking medications not on their medication list) were found in 50% and 72% of the patients found to have a medication error, respectively.
Conclusions: VASD’s HiH program demonstrated that hospital‐level of care delivered at home can safely reduce inpatient utilization, has the potential to lower costs, reduce medication errors, and achieve high patient satisfaction within a VA setting.