Rural Americans are facing a health care crisis. 23% of the country’s 60 million people living in rural settings report access to health care as a major problem. People must choose between driving long distances to seek care for acute illnesses or simply going without needed care. Meanwhile, rural hospitals are struggling to remain open, with 129 facilities closing since 2010. For many hospitals, the cost of supporting a traditional rural hospital infrastructure has become unsustainable.
Ariadne Labs’ Rural Home Hospital project is testing a solution to the growing challenges of rural health care in America by providing patients with acute, hospital-level care in their homes as a substitute for traditional hospital care. If successful, this model would alleviate issues of access, safety, and quality that so many patients are facing, and help lower the costs of providing care in rural settings.
The project has completed design, testing, and proof-of-concept phases and now wants to test rural home hospital care through a randomized controlled trial. Ariadne Labs is seeking rural hospital partners interested in launching their own rural home hospital program. Access our request for proposals here.
The Ariadne Labs project is led by David Levine, MD, MPH, MA, a physician at Brigham and Women’s Hospital, and lead author on a study that examined the benefits of a similar model used in urban settings. That study demonstrated that hospital-level care could be delivered in a patient’s home with similar or better quality and patient experience but at a lower cost than traditional hospital care.
“We have the data to show a home-based acute care model works in an urban setting,” says Levine. “However, there are fundamental differences between delivering care in urban and rural settings. This trial will help us build the evidence base we need to really scale this model to rural areas across the country and will help us to ensure that the positive effects on cost and quality in urban settings hold true in rural settings.”
Each study site will receive hands-on, technical support from Ariadne Labs to design and launch a rural home hospital model. In addition, each site will receive $190,000 to secure the right technology and equipment, subsidize staffing costs, designate a study coordinator, and more. The trial will run for up to 18 months and, given the long-term cost savings associated with this model of care, it is expected that the programs implemented during the trial will be self-sustaining by completion of the trial.
Sites will be asked to recruit 25 patients to take part in the study, with a focus on patients with exacerbations of a chronic condition, such as COPD or heart disease.
“We see this model as the future of health care,” said Levine. “Especially in the context of COVID-19, where we’ve seen so much of health care become more virtual and more digital almost overnight, this model presents an opportunity for rural hospitals to begin to move into the digital future, optimize their capacity, and create a more sustainable model of care to better serve their patients.”