345 - A US Pilot Pediatric Hospital at Home: Who Are Our Patients?

Publication Number: 4338.345

Tonya K. Obita, Levine Children's Hospital, Mint Hill, NC, United States; Stefanie Reed, Levine Children's Hospital, Charlotte, NC, United States; Sara Horstmann, Levine Children's Hospital, Cornelius, NC, United States; Douglas A. Dodds, Levine Children's Hospital, Cornelius, NC, United States; David Marseille, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Charlotte, NC, United States; Dustin Long, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Gang Liu, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Charlotte, NC, United States; Christine B. Turley, Atrium Health Levine Childrens, Wake Forest University SOM, Charlotte, NC, United States

Background: During the COVID-19 pandemic, our institution successfully used an adult hospital at home (AH@H) program to expand capacity. Our Pediatric Hospital Medicine (PHM) department faces a similar capacity challenge, spending 90% of 2024 at or exceeding capacity. While pediatric acute hospital at home (PAH@H) is used internationally for some acute care, US pediatric medicine has not integrated this model into inpatient pediatric medicine. In February 2025, our PHM department launched a PAH@H program, focused on building a model of providing acute hospital level care directly in a patient's home.

Objective: Describe the initial cohort of patients receiving care in a pilot US PH@H Unit.

Design/Methods: After meeting criteria on both medical screening and an environment interview assessment, patients were invited to transfer to PAH@H. Characteristics of patients participating in the program are described using standard descriptive statistics. We also tracked 30-day readmission and transfer back to brick-and-mortar (BAM). Local IRB approval was obtained prior to initiation of the program.

Results: In the first 7 months of our program, 118/149 eligible (79%), patients consented and received care in the PAH@H unit. The top 3 diagnoses were dehydration, feeding difficulty, and treatment of infection. Table 1 summarizes the characteristics of patients by month enrolled.

Conclusion(s): In the first 7 months the majority of families offered this model chose to enroll. The unit has served a range of patient ages and diagnoses, and few have needed to be transferred back to the BAM hospital. Overall length of stay may be longer but this needs further analysis with a larger cohort of patients before conclusions are certain.

Table 1: Characteristics of Patients in Pediatric Acute Hospital at Home