Home Hospitalizations Surge in Israel, Easing Hospital Bed Strain

A report released by Israel's Ministry of Health reveals a dramatic increase in home hospitalization services, offering an alternative to inpatient care and alleviating pressure on hospital departments. Between 2018 and 2024, the number of acute home hospitalizations has grown exponentially from 136 to approximately 38,000 annually. Over this period, around 115,000 home hospitalizations have been conducted, including for COVID-19 patients, with the total number of days spent in home care skyrocketing from hundreds to about 162,000 in 2024.

Data from 2021-2024 indicates that 73% of home hospitalization patients were aged 65 and above, with 56% being 75 or older. The average length of stay was 4.4 days, longer than general internal medicine wards but shorter than geriatric internal medicine wards. The most common diagnoses treated at home, often involving intravenous antibiotics, include pneumonia (19%), urinary tract infections (17.8%), cellulitis (13.6%), dehydration (8.6%), and heart failure (5.6%).

In 2024, an average of 445 patients were simultaneously under home hospitalization daily, equivalent to about one-tenth of the capacity of general and geriatric internal medicine departments. During peak months, this number reached around 600, comparable to 17 internal medicine wards. This signifies that over 10% of internal medicine inpatient activity now occurs at the patient's home.

The report also notes a significant decrease in occupancy rates in internal medicine wards, dropping to approximately 87% in 2024 from nearly 100% before 2019. This decline may be attributed to the rise of home hospitalizations or regulatory changes. While health maintenance organizations (HMOs) primarily provided home hospitalization services until 2025, the Ministry of Health has encouraged hospitals to offer the service, with legislation now in place for 2026-2030 to expand its availability to more patients.