Home Hospitalization Surges in Israel, Outpacing Global Trends

A report from Israel's Ministry of Health reveals a dramatic expansion of acute home hospitalization services, transforming it from a niche offering to a significant part of the country's healthcare system. Between 2018 and 2024, the number of home hospitalizations skyrocketed from 136 to approximately 38,000 annually. In peak winter months, around 600 patients were treated at home concurrently, a volume equivalent to about 17 internal medicine departments.

This surge represents about 12% of all internal medicine admissions and 11% of hospitalization days in the relevant departments in 2024. This growth is particularly notable given Israel's shortage of hospital beds, with 3 beds per 1,000 residents compared to the OECD average of 4.2. Home hospitalization offers flexibility, allowing services to scale up during high-demand periods like winter.

The service is designed for patients with stable conditions requiring hospital-level care but who can be safely managed at home, often involving doctor and nurse visits, IV antibiotics, and monitoring. Common diagnoses include pneumonia, UTIs, cellulitis, dehydration, and heart failure, with the majority of patients being elderly.

While home hospitalization is not unique to Israel, with similar models existing in countries like France, Spain, and Australia, Israel's reported 12% rate within specific internal medicine frameworks appears high. However, direct international comparisons are complex due to differing definitions and measurement methods.

Despite the rapid growth, the report highlights challenges, including inconsistent use of remote monitoring technology, limited involvement of other healthcare professions, and uneven geographical distribution, with lower rates in socioeconomically disadvantaged areas. Concerns also remain about ensuring the home environment is suitable and that family members are not overburdened with medical tasks.

The Ministry of Health has invested over half a billion shekels in home hospitalization since mid-2018, with a dedicated budget of approximately 220 million shekels allocated for hospital involvement over the next five years. While home hospitalization can alleviate pressure on hospitals and offer a familiar treatment environment, it is not a complete substitute for hospital beds and requires careful patient selection, adequate monitoring, and accessible staff to ensure safe, equitable, and quality care.