Home Hospitalizations in Israel Surge 280-Fold, Replacing Hospital Wards

Home hospitalization in Israel has experienced a dramatic increase, soaring from just 136 cases in 2018 to approximately 38,000 in 2024, according to a new report from the Ministry of Health's Policy Planning Division. Over this period, a total of around 115,000 home hospitalizations were conducted. In 2024, an average of 445 patients were under home hospitalization daily, a volume equivalent to about one-tenth of the capacity of internal medicine and geriatric wards nationwide. At its peak in February 2024, the number of concurrent home hospitalizations reached about 600, a figure comparable to 17 physical internal medicine wards.

This significant expansion has demonstrably eased hospital congestion. While internal medicine ward occupancy stood at around 100% until 2019, it dropped to 87% in general internal medicine and 67% in geriatric internal medicine wards by 2024. The overall per capita hospitalization rate in Israel continues to decline, indicating that home hospitalization serves as a direct substitute for traditional hospital care rather than an addition to it.

The service primarily caters to the elderly population, with 73% of patients aged 65 and above, and 65% aged 75 and above. The average length of stay is 4.4 days. Common diagnoses include pneumonia (19%), urinary tract infections (17.8%), cellulitis (13.6%), dehydration (8.6%), and heart failure (5.6%).

Approximately 84% of patients are referred directly from the community, though the rate of referrals from hospitals has risen from 10% in 2021 to 19% in 2024. In peripheral areas, the overall hospitalization rate was 3.5 per 1,000 people, but for those aged 65 and over, it exceeded the national average, reaching 24.2 compared to the national average of 21.4.

Since 2018, budgetary support for health maintenance organizations (HMOs) has totaled approximately NIS 550 million, with about NIS 202 million allocated in 2024. Following a pilot during Operation "With All Your Might," hospital involvement as service providers was formalized in 2026 with a dedicated five-year budget of NIS 220 million. This includes a "right of first refusal" mechanism granting HMOs priority in service provision.