Implementation of hospital at home
Authors: Farfan-Portet Maria-Isabel , Denis Alain , Mergaert Lut , Daue François , Mistiaen Patriek , Gerkens Sophie 
Published: January 2025

INTRODUCTION 6 -- 1 NARRATIVE LITERATURE REVIEW ABOUT EFFECTIVENESS AND SAFETY .6 -- 1.1 OBJECTIVE OF THE CHAPTER 6 -- 1.2 METHOD 6 -- 1.3 RESULTS 8 -- 1.3.1 Search and inclusion .8 -- 1.3.2 Methodological assessment 9 -- 1.3.3 Content-analysis SRs .11 -- 1.4 DISCUSSION 15 -- 1.5 LIMITATION 18 -- 2 INTERNATIONAL COMPARISON 18 -- 2.1 METHODS 19 -- 2.1.1 Analytical framework 19 -- 2.1.2 Selection of countries 19 -- 2.2 HEALTH SYSTEMS IN BRIEF 20 -- 2.2.1 Hospital financing 20 -- 2.2.2 Home nursing care 20 -- 2.2.3 General practitioner (GP) 21 -- 2.3 OBJECTIVES OF HAH IMPLEMENTATION 24 -- 2.4 VARIOUS MODELS OF HAH ORGANIZATION 24 -- 2.5 SCREENING ACTIVITIES AND HAH ADMISSION DECISION 26 -- 2.5.1 Screening activities and patient referral process 26 -- 2.5.2 Admission decision 27 -- 2.6 PLANNING, PROVISION AND COORDINATION OF CARE 28 -- 2.6.1 Which HAH activities are provided? 29 -- 2.6.2 Care coordination and the care plan 29 -- 2.7 PROVIDE RESPONSE IN CASE OF EMERGENCY 30 -- 2.8 PATIENTS AND FAMILIES SATISFACTION, EMPOWERMENT AND SUPPORT 31 -- 2.8.1 Patients and families empowerment and support 31 -- 2.8.2 Patient satisfaction 31 -- 2.9 INTEGRATION OF ACTIVITIES WITHIN THE HEALTH SYSTEM 32 -- 2.10 IMPLEMENTATION AND FOLLOW-UP: WHAT IS THE DEMAND FOR SERVICES? 34 -- 2.10.1 Common points between countries 34 -- 2.10.2 Differences between countries 35 -- 2.11 WHAT REQUIREMENTS MUST BE MET? 37 -- 2.11.1 Framework 37 -- 2.11.2 Workforce .39 -- 2.11.3 Financing 43 -- 2.11.4 Processes in support of quality of care 46 -- 2.11.5 Decision support 47 -- 2.11.6 IT tools 47 -- 2.12 LIMITATIONS 49 -- 3 BELGIAN SITUATION .50 -- 3.1 OBJECTIVE OF THE CHAPTER 50 -- 3.2 METHODS 50 -- 3.3 BELGIAN HEALTH SYSTEM IN BRIEF 50 -- 3.3.1 Hospital financing 50 -- 3.3.2 Home nursing care 50 -- 3.3.3 General Practitioner 51 -- 3.3.4 Current structured programs providing (acute) home medical or transmural care 51 -- 3.4 OBJECTIVES OF HAH IMPLEMENTATION IN BELGIUM 51 -- 3.5 SCREENING ACTIVITIES 52 -- 3.6 PLANNING, PROVISION AND COORDINATION OF CARE 52 -- 3.6.1 Which pathologies  patients? 52 -- 3.6.2 Specificities of a care plan 52 -- 3.6.3 Coordination of care and case management 52 -- 3.7 PROVIDE ACUTE EPISODE RESPONSE AND SPECIALIZED SERVICES 53 -- 3.8 PATIENTS AND FAMILIES SATISFACTION, EMPOWERMENT AND SUPPORT 54 -- 3.9 INTEGRATION OF ACTIVITIES WITHIN THE HEALTH SYSTEM 55 -- 3.9.1 Improving the coordination between settings 55 -- 3.9.2 Ensuring the continuity of care 55 -- 3.9.3 Seamless care with regard to medications 55 -- 3.9.4 Rethinking boundaries in primary care provision 56 -- 3.9.5 Building bridges between different levels of governance 56 -- 3.10 WHAT REQUIREMENTS MUST BE MET 56 -- 3.10.1 Framework 56 -- 3.10.2 Workforce 58 -- 3.10.3 Financing 60 -- 3.10.4 Processes in support of quality of care 63 -- 3.10.5 Decision support 64 -- 3.10.6 IT tools 65 -- 3.11 LIMITATIONS 65 -- 4 DISCUSSION OF POSSIBILITIES FOR THE IMPLEMENTATION OF HAH IN BELGIUM 66 -- 4.1 INTRODUCTION 66 -- 4.2 METHODOLOGY 66 -- 4.2.1 Step 1: Preparation 66 -- 4.2.2 Step 2: Face-to-face interviews 67 -- 4.2.3 Step 3: Workshop with stakeholders 68 -- 4.3 RESULTS 69 -- 4.3.1 Expected impact and objectives to be pursued 69 -- 4.3.2 Target groups for HAH 70 -- 4.3.3 Organisation of HAH 71 -- 4.3.4 Roles and responsibilities for the different actors 72 -- 4.3.5 Conditions for the implementation of HAH 75 -- 4.3.6 Options for the financing of HAH .77 4.3.7 Operational support 78 -- 4.3.8 Planning the process 80 -- 4.4 DISCUSSION 80 -- 4.5 LIMITATIONS 81 -- REFERENCES 82