Hospital-at-home.

Hospital-at-home schemes are becoming an increasingly popular way of delivering health care world-wide. Schemes differ in the type of patients they cater for and in the intensity and complexity of treatment they provide. Although they have been in existence since 1961, there have been few randomized controlled studies to determine their effectiveness as an alternative to standard hospital care. Furthermore, some studies have produced conflicting results. Although there is accumulating evidence that they produce satisfactory patient outcomes and are acceptable to patients and carers, their cost-effectiveness is still uncertain. Further randomized controlled studies incorporating prospective cost analyses are needed. This paper discusses the evidence to support hospital-at-home as an alternative and complementary model of health care particularly for older people.