Home Hospitalizations in Israel Surge Nearly 280-Fold in Six Years

Home hospitalization services in Israel have experienced a dramatic expansion, growing from a limited offering to a significant component of the healthcare system. A new report from the Ministry of Health reveals that acute home hospitalizations increased from just 136 in 2018 to approximately 38,000 in 2024, a nearly 280-fold increase in six years. During this period, around 115,000 home hospitalizations were conducted, including for COVID-19 patients.

Acute home hospitalization is designed as an alternative to inpatient care in internal medicine departments for suitable patients, providing advanced medical treatment at home while ensuring safety and continuity of care. The report highlights that Israel's general hospital bed availability per capita is below the OECD average, while the population grows and ages, increasing demand for hospital services.

In 2024, home hospitalization days reached about 162,000, compared to hundreds in 2018. On average, around 445 patients were under home hospitalization daily, equivalent to about one-tenth of the capacity of general and geriatric internal medicine departments. During peak months, approximately 600 patients were treated at home concurrently, a volume comparable to 17 internal medicine departments.

The service primarily serves the elderly population, with 73% of home-hospitalized patients aged 65 and over, and 56% aged 75 and over between 2021 and 2024. The average length of stay was 4.4 days, with common diagnoses including pneumonia, urinary tract infections, cellulitis, dehydration, and heart failure.

Between 2021 and 2024, about 84% of patients were referred for home hospitalization directly from the community, with only 16% from hospitals. However, hospital referrals have steadily increased from 10% in 2021 to 19% in 2024. This shift is supported by legislation and approximately 220 million shekels allocated over five years.

The Ministry of Health emphasizes the need for a unified national model to further regulate the field, including expanding target populations, strengthening collaboration between hospitals and health funds, developing remote monitoring, improving referral mechanisms, and reducing disparities in service provision, particularly in peripheral areas. The ministry anticipates continued expansion of home hospitalization to address an aging population and hospital overcrowding, moving towards a model where hospitals play a more significant role alongside health funds.