Home-based healthcare eases burden for elderly

Whenever her bedridden 85-year-old father develops a fever and has to be hospitalized, Wang Aijing said she gets tense, stressing over the risk of cross-infection at the hospital and whether she could take time off work to care for him.

"My dad has spinocerebellar ataxia and has to be taken to hospital by ambulance. This situation presents me with a series of frenetic and overwhelming tasks," said Wang, a resident of Luoyang in Henan province.

Spinocerebellar ataxia is a progressive disorder caused by the degeneration of cells in the brain and spinal cord, and it can lead to uncoordinated movement and muscle wasting.

But since October, Wang has been trying something different. She enrolled her father in a trial program providing hospital care at home, which was launched as part of efforts to improve the patient experience and ease hospital overcrowding.

"About two to three days after we submitted an application, staff were sent to evaluate whether my father's condition and his residence were suitable for home-based hospital care," Wang said.

"After he was accepted, a doctor would come to my father's bedside to treat his fever or check his condition when he was coughing severely."

With the hospital-at-home program and the help from a live-in caregiver, Wang said she felt much more reassured about his condition.

"Although my dad has Alzheimer's disease and does not talk much, I can tell from his facial expression that being at home makes him feel more relaxed.

"I think the biggest benefit of the program for our family is that we know where to seek help when my father is feeling unwell, and this is extremely convenient."

Five cities in Henan, including Luoyang, have been designated to pilot the home-based hospital service model, according to a circular released in May by the provincial authorities.

The program targets seven types of patients who need hospitalization but cannot visit hospitals due to mobility impairment, such as those with chronic respiratory illness and who receive long-term oxygen therapy or noninvasive respiratory support, and patients who are paralyzed due to a cerebral vascular accident and require regular rehabilitation.

At home, they can access regular health monitoring and basic treatment, and receive some examinations including electrocardiogram and imaging tests. Services are mainly provided by community health centers or rural clinics, as well as some major hospitals.

At a healthcare service center in Luoyang's Chang'an Road subdistrict, 13 patients have joined the program since August, said Ma Qinying, a doctor at the center, during an interview in early November.

The majority of them have chronic conditions such as high blood pressure or diabetes, long-term problems following a stroke or have recently broken bones, Ma said.

"In one case, an elderly patient used to visit the hospital in person for minor ailments such as a cold or fever. But through our program, the elderly can get medication and care at home. The senior's family members spoke highly of the program's convenience, because they no longer need to find and hire a caregiver at the hospital and rush between their home and the hospital," she said.

Ma added that each patient also gets at least two weekly in-person checks and their regular needs can also be met promptly.

Luoyang has also set up an information and surveillance system for at-home hospital services. "If an emergency occurs which is beyond our capacity, we would also help them call an ambulance, get in touch with a higher-level hospital and accelerate the patient's transfer there," Ma said.

Jin Jie, head of the community health center, said that one round of home-based hospital services — which should last no longer than 90 days in most cases — costs 90 yuan ($12.6), and each door-to-door visit would cost 50 yuan, but the patients only need to pay 10 yuan and five yuan, respectively, thanks to medical reimbursement policies.

"A growing number of the elderly have trouble in making in-person hospital visits, and the program really saves them a lot of time," Jin said, adding that the key to the program's success is guaranteeing safe and effective medical services.

"We are now exploring the deployment of smart and internet tools, as well as telemedicine, to obtain guidance from senior medical professionals to improve quality of our services."

Qi Xin in Zhengzhou contributed to this story.

Contact the writers at wangxiaoyu@chinadaily.com.cn