Israel's Home Hospitalization Soars, Offering Alternative to Inpatient Care

The Israeli Ministry of Health has released a report detailing a dramatic surge in home hospitalization services, which are increasingly serving as an alternative to traditional hospital stays. Between 2018 and 2024, the number of acute home hospitalization cases skyrocketed from 136 to approximately 38,000. Over this period, nearly 115,000 home hospitalizations were conducted, including for COVID-19 patients. The number of days spent in home hospitalization also grew significantly, from a few hundred in 2018 to about 162,000 in 2024.

In 2024, an average of 445 patients daily received home hospitalization, equivalent to about 10% of the capacity of general internal medicine and geriatric internal medicine departments. During peak months, this figure reached around 600 patients, comparable to 17 internal medicine wards. Home hospitalization now accounts for roughly 12% of all internal medicine admissions and 11% of hospitalization days in relevant departments. This expansion has coincided with a notable decrease in the occupancy rates of internal medicine wards, dropping from nearly 100% before 2019 to about 87% in 2024.

Initially provided primarily by health maintenance organizations (HMOs), home hospitalization services were expanded to include hospitals following Operation "Northern Shield." Regulatory changes and financial incentives, particularly within the "Cap on Internal Medicine Departments" law, have encouraged this growth. The report highlights that 73% of home hospitalization patients in 2021-2024 were aged 65 and over, with 56% being 75 or older. The average length of stay was 4.4 days. Common diagnoses include pneumonia, urinary tract infections, cellulitis, dehydration, and heart failure.

The report indicates that while 84% of home hospitalizations were initially referred from the community, hospital referrals have been steadily increasing. The service demonstrates operational flexibility, expanding and contracting based on demand, particularly during winter months. The Ministry of Health is exploring further expansion into pediatrics, geriatrics, surgery, oncology, cardiology, and psychiatry, requiring adjustments to operational models and funding mechanisms. A standardized reporting system is deemed crucial for systematic measurement and quality control.