Home Hospitalizations Surge in Israel, Now 12% of Internal Medicine Care

Home hospitalization services in Israel have seen a dramatic increase, transforming from an experimental program into a significant component of the healthcare system. According to a special report by the Ministry of Health, the number of home hospitalizations jumped from just 136 in 2018 to approximately 38,000 in 2024, equating to 3.9 such admissions per 1,000 residents. Cumulatively, around 115,000 home hospitalizations were conducted between 2018 and 2024.

More significantly, home hospitalizations now account for about 12% of all admissions to internal medicine departments and 11% of internal medicine hospitalization days. This indicates that over a tenth of traditional internal medicine care is now being provided at patients' homes. In terms of capacity, this service is equivalent to roughly 17 internal medicine departments, with an average of 445 patients under home care at any given time in 2024, peaking at around 600.

The expansion of home hospitalization is occurring against a backdrop of prolonged stagnation in hospital bed availability relative to the population. Between 2014 and 2024, internal medicine departments added only about 170 beds, a mere 4% increase, while the rate of beds per 1,000 residents dropped from 0.50 to 0.44. For individuals aged 65 and over, the decline is even steeper, with beds per 1,000 decreasing by approximately 27%.

The report suggests that home hospitalization is largely replacing institutional admissions rather than adding to the overall number of hospitalizations. The primary demographic for home care is the elderly, with 73% of patients aged 65 and over between 2021 and 2024, and a median age of 77. Common diagnoses include pneumonia, urinary tract infections, cellulitis, dehydration, and heart failure.

Geographically, the service is not evenly distributed. While peripheral areas generally keep pace with the national average for home hospitalizations, a deeper analysis reveals a stark disparity. Less peripheral areas (clusters 3-4) show the highest rates of home hospitalization for those over 65, whereas the most remote areas (clusters 1-2) have rates that are only a third of the national average.

Despite the service's success, the Ministry of Health warns of potential stagnation due to funding uncertainty. The growth rate of home hospitalization days has slowed, attributed by providers to a lack of guaranteed long-term budget allocation. The Ministry emphasizes that securing stable funding and improving accessibility in the deepest periphery are the next critical challenges for this vital healthcare component.