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Objectives The ability to deliver SNF-level care at home is unclear. We sought to demonstrate the feasibility of rehabilitation at home (RAH) via a pilot randomized controlled trial. Methods Daily care from a home health aide, certified nursing assistant, nurse, and physician. Core technologies included remote PT, automated medication dispensing, and continuous monitoring. Primary outcome: episode cost. Results We randomized 10 patients. Home patients’ episode cost a median $8404 (IQR, $2697) versus $9215 (IQR, $5702). LOS for both was 14 days. Home patients’ ADLs improved between admission and 30-days post-discharge by median 4 (IQR, 5) versus 1 (IQR, 2). Home patients’ median Picker patient experience score was 12/14 (IQR, 2) versus 7/14 (IQR, 3). Discussion A RAH pilot compared favorably to traditional SNF, with trends toward lower cost, greater functional status improvement, and better patient experience. This delivery innovation could reimagine how we deliver post-acute care but requires replication. Clinicaltrials.gov registration NCT04048590. |
