Israel Allocates Official Funding to Expand Home Hospitalization Services Nationwide
For the first time in Israel's history, home hospitalization has received official government budget allocation. As part of the multi-year financial agreement known as the "Cap Law," which manages about 20 billion shekels annually between health funds and hospitals, dedicated sums have been earmarked for home hospitalization: 30 million shekels this year, 40 million next year, and 50 million annually starting in 2028. The government aims that within 15 years, one in seven hospitalizations will take place at patients' homes rather than in hospital wards.
This initiative responds to chronic bed shortages in internal medicine departments, which often exceed 100% occupancy, an aging population, and the high risk of hospital-acquired infections, especially for vulnerable patients. Recent military conflicts highlighted the strategic need to treat patients at home when hospitals must free up beds for emergencies. Home hospitalizations have surged dramatically, from fewer than 200 cases in 2018 to over 40,000 last year, with nearly a quarter of hospital referrals now directed to home care.
Central to this transformation is Tzabar Refuah, Israel's largest home hospital operator, which recently expanded its services in collaboration with Ichilov Medical Center to include new departments such as psychiatry, ENT, neurosurgery, plastic surgery, urology, and internal medicine, in addition to existing cardiology and surgical home care. Patients remain officially admitted to the hospital department that referred them, while a dedicated medical team visits daily or as needed. The service also provides 24/7 professional support, ambulance transport, medication and equipment delivery, home blood and urine tests, and transportation for imaging exams.
Dr. Inbal Maayan, Tzabar Refuah's medical director and a geriatrician, noted a significant shift in hospital attitudes since home hospitalization was included in the Cap Law. She said, "There is no longer debate about entering this field; the only question is the timeline. Everyone understands home hospitalization will be a central pillar of Israeli healthcare's future." Dr. Maayan emphasized that the elderly benefit most from this model, as about one-third of internal medicine inpatients, where occupancy rates range from 95% to 105%, could receive full treatment at home or in nursing facilities. She added, "For older adults, home hospitalization is not only more comfortable but safer, reducing confusion and complications and enabling faster recovery. It is painful to see crowded wards knowing many patients could heal at home with equal professionalism in a familiar environment."
