Costs and Cost AnalysisNCT07274072
Hospital at Home Versus Inpatient Care: Costs and Effectiveness
An observational study of Costs and Cost Analysis and Effectiveness, run by Hospital at Home AG at 1 site in Switzerland.
Trial summary
Background and Objectives Hospital at Home (HaH) delivers hospital-level treatment to acutely ill patients in their own homes, including daily medical and nursing visits, infusions, physiotherapy, and diagnostics. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Costs and Cost Analysis, Effectiveness, Patient Satisfaction
- How many people
- 200 participants
- Where
- 1 siteSwitzerland
- Study dates
- 1 Sep 2025to 31 Aug 2026
- How long will I take part?
- 1 Day
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: 200 participants total, 100 from the regular hospital ("brick and mortar"), 100 from Hospital at Home. Patients from 18years of age upwards with a disease treated in the hospital or in hospital at home.
Who may be able to join
- Inpatients in the hospital or patients in Hospital at Home care
- Age ≥ 18 years
- Admission due to a typical Hospital at Home diagnosis (mild to moderate inflammatory and infectious diseases of the lungs, urinary tract, gastrointestinal tract, heart, and skin; exacerbated chronic obstructive pulmonary disease; exacerbation of chronic heart failure; wounds; bleeding/anemia; dehydration; deterioration of general condition in multimorbid patients; infection-related complications in oncological patients; psychiatric problems including delirium; metabolic or autoimmune diseases; orthopedic patients; pain exacerbations of any cause; palliative patients up to and including terminal situations)
- Patients without severe cognitive impairment or dysfunction who are capable of providing informed consent and/or completing the questionnaire
- Patients with sufficient proficiency in written and spoken German and/or English
Who cannot join
- Inpatient admission for other reasons
- Refusal to provide informed consent
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Switzerland1 site, 1 recruiting
- Recruiting
Hospital at Home AG
Zollikon, Canton of Zurich, 8702
About this study
Background and Objectives Hospital at Home (HaH) delivers hospital-level treatment to acutely ill patients in their own homes, including daily medical and nursing visits, infusions, physiotherapy, and diagnostics. It bridges inpatient and outpatient care, working closely with hospitals, office-based physicians, home care services (Spitex), and therapy providers.
There are two main pathways:
Read more
Admission Avoidance: stable patients requiring hospitalization are admitted directly to HaH instead of an inpatient ward.
Early Supported Discharge: patients treated in hospital are discharged earlier than usual and transferred to HaH.
Evidence International studies show HaH to be safe and effective. Reviews report comparable mortality and rehospitalization, shorter hospital stays, and cost advantages. Admission avoidance is linked to trends toward lower mortality and costs. Research showed similar mortality but fewer rehospitalizations, longer treatment duration, and reduced risks of institutionalization, depression, and anxiety. HaH patients were older, with reduced daily living activities, yet care costs were on average USD 5,054 lower than inpatient care.
In Switzerland, the mean hospital stay in 2019 was 8 days (acute somatic: 5.2; psychiatry: 33.5).
Study Hypotheses
HaH can be delivered at equal or lower cost than regular hospitalization.
HaH care is safe, with few complications, and yields high patient satisfaction.
Study Objective To demonstrate that hospital-equivalent home treatment of acutely ill patients is effective, appropriate, cost-efficient (according to Swiss WZW criteria), safe, and associated with high satisfaction and low complication rates compared with inpatient care.
Endpoints
Primary: Costs - HaH vs. inpatient care at Hirslanden Clinic, using REKOLE® cost accounting.
Secondary: Mortality, therapy type, monitoring, diagnostics, rehospitalization, complications, satisfaction, patient-reported outcomes, length of stay, referrals to nursing homes, follow-up after discharge, ED visits, rehabilitation referrals, and home care type.
Read the detailed description
- BACKGROUND AND SIGNIFICANCE OF THE STUDY The Hospital at Home concept enables hospital-equivalent treatment of acutely ill patients requiring hospitalization in their own homes. Treatment is carried out as in a regular hospital, with daily visits by physicians and nurses. In addition to disease management, including infusion therapies, home-based physiotherapy and diagnostic procedures such as blood and urine testing, ultrasound, and electrocardiography are provided. This positions Hospital at Home at the interface between traditional inpatient and outpatient care, complementing the existing services of hospitals, office-based physicians, home care organizations (Spitex), physiotherapy, and occupational therapy through a structured treatment process at the patient's home. Care is not provided in isolation but in cooperation with the aforementioned established institutions. Two referral pathways into Hospital at Home can be distinguished: Admission Avoidance: eligible patients in stable general condition with an acute illness that would normally require hospitalization are admitted directly into Hospital at Home instead of inpatient care and treated equivalently at home. Early Supported Discharge: patients already treated in a regular hospital and in good general condition are discharged earlier than usual and transferred to Hospital at Home, where treatment is completed. Hospital at Home has been investigated in various international studies. A review found, patients assigned to Hospital at Home via early supported discharge showed comparable mortality and rehospitalization rates and shorter hospital stays. Patients admitted via admission avoidance showed a trend towards lower mortality and costs and comparable rehospitalization rates. Further research found similar mortality rates between Hospital at Home and regular inpatients, but lower rehospitalization rates and longer treatment durations in the Hospital at Home group. It also showed lower risk of institutionalization in long-term care facilities, as well as a reduced risk of depression and anxiety. A retrospective observational study from New York, USA, showed, that Hospital at Home patients were on average older and showed reduced activities of daily living. The costs of Hospital at Home care were on average USD 5054 lower than those of comparable inpatients. In Switzerland in 2019, the average length of stay across all hospital sectors was 8.0 days, with the shortest in acute somatic care (5.2 days) and the longest in psychiatry (33.5 days).
- PROJECT OBJECTIVES AND DESIGN 2.1 Hypotheses and Primary Study Objective
Hypothesis 1 Care through Hospital at Home can be delivered at equivalent or lower cost compared to regular hospitalization.
Hypothesis 2 Hospital at Home care is safe for patients, associated with few complications, and yields high patient satisfaction.
Study Objective Our study aims to demonstrate that hospital-equivalent treatment of acutely ill patients at home is effective, appropriate, and cost-efficient (according to the Swiss WZW criteria) and, compared with regular inpatient care, is safe, associated with low complication rates, and achieves high patient satisfaction.
2.2 Primary and Secondary Endpoints
Primary Endpoint:
Costs: Treatment in Hospital at Home can be cost-equivalent or more cost-effective compared to regular inpatient care. Patient data from Hospital at Home AG will be compared with patient data from regular inpatients at Hirslanden Clinic. Costs, or billable tariffs, will be considered based on cost accounting according to REKOLE®.
Secondary Endpoints (as defined in section 3.3 "Additional Study Variables"):
Mortality
Type of therapy
Type of monitoring
Type and frequency of diagnostics
Rehospitalization during and after treatment
Complications and complication rates
Patient satisfaction
Patient-related outcomes
Length of stay
Referrals to nursing homes or long-term care after discharge
Follow-up with general practitioner or specialist after discharge
Emergency department visits during treatment and after discharge
Referral to rehabilitation clinics after discharge
Type of home care after discharge
- Conditions
- Costs and Cost Analysis, Effectiveness, Patient Satisfaction
- Keywords
- hospital at home, costs, clinical outcome, patient satisfaction
- Medical subject headings
- Patient Satisfaction
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Hospital at Home Group | 100 participants treated in hospital at home | |
| Regular hospital group/"Brick and mortar group" | 100 participants treated in the hospital |
What is being measured
The primary outcome is the main question the study is designed to answer.
Costs
Comparison of cost of treatment in Hospital at Home vs. regular hospital ("brick and mortar"). Data will be collected via financal data of both groups, 100 patients from the regular hospital (Klinik Hirslanden Zurich) and 100 patients from Hospital at Home AG (Zollikon)
Measured: 1 year or until the total of 200 participants are included
Secondary outcomes (3)
Effectiveness (clinical outcome)
Measure of how effective the treatment in Hospital at Home vs. regular hospital ("brick and mortar") is. The clinical outcome will be measured by: Mortality up to 30 days after discharge, emergency-admission up to 30 days after discharge, readmission to the hospital/H@H up to 30 days after discharge, GP-consultation up to 30 days after discharge, specialist-consultation up to 30 days after discharge, admission to nursing home up to 30 days after discharge. Data will be collected through patient data, collected via clinical information system and phone calls to the patient 30 days after discharge.
Measured: 1 year or until the total of 200 participants are included
Effectivness (complications)
Measure of how effective the treatment in Hospital at Home vs. regular hospital ("brick and mortar") is. The clinical outcome will be measured by measuring the number and kind of complication. We will collect data regarding number of falls, (up to 30 days after discharge), number of new infections during treatment, development of bedsores during treatment (yes/no), development of delirium during treatment (yes/no), thrombosis during treatment (yes/no). Data will be collected through patient data, collected via clinical information system and phone calls to the patient 30 days after discharge.
Measured: 1 year or until the total of 200 participants are included
Patient satisfaction
How satisfied are the patients treated in Hospital at Home compared to patients treated in the regular hospital ("brick and mortar"), measured by patient questionnaires. First questionnaire (patient satisfaction) consists of 8 questions each reaching from 0-5 points (0 = worst, 5 = best) regarding overall assessment, recommendation of service, assessment by relatives, competencies of nurses, competencies of doctors, quality of hotline, satisfaction with communication/flow of information and safety. Second questionnaire ist the PROMIS Globla health 10 consisting of 10 questions, first 9 reaching from 1-5, last question reaching from 0-10 points. The questions assess global well-being, quality of life, physical and psychological well-being, satisfaction with level of activity, handling of everyday activities, handling of everyday phsysical tasks, mental problems, tiredness, pain. Data will be collected through patient data, collected via clinical information system and phone calls.
Measured: 1 year or until the total of 200 participants are included
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Dec 2025
- Study start1 Sep 2025
- Primary completion31 Aug 2026 (estimated)
- Study completion31 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Costs and Cost AnalysisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Prospective
- Enrolment
- 200 participants (estimated)
- Target duration
- 1 Day
Sponsor and investigators
- Lead sponsor
- Hospital at Home AG
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Klinik Hirslanden, Zurich
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07274072
- Sponsor's protocol ID
- 2025-00482
- Other IDs
- 2025
- Status last verified
- Dec 2025
- First submitted
- 22 Sep 2025
- Last updated
- 10 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: Would be interesting to compare data with other Hospital at Home programs, but no plans are yet made.
Publications
Leong MQ, Lim CW, Lai YF. Comparison of Hospital-at-Home models: a systematic review of reviews. BMJ Open. 2021 Jan 29;11(1):e043285. doi: 10.1136/bmjopen-2020-043285.
PubMed 33514582
Study at a glance
From the registry record, last updated by the sponsor on 10 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Hospital at Home Versus Inpatient Care: Costs and Effectiveness
- ClinicalTrials.gov ID
- NCT07274072
- Acronym / sponsor ID
- 2025-00482
- Conditions
- Costs and Cost Analysis, Effectiveness, Patient Satisfaction
- Keywords
- hospital at home, costs, clinical outcome, patient satisfaction
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- Hospital at Home AGIndustry (pharma, biotech, devices)
- Collaborators
- Klinik Hirslanden, Zurich
- Study start
- 1 Sep 2025 (actual)
- Primary completion
- 31 Aug 2026 (estimated)
- Study completion
- 31 Aug 2026 (estimated)
- First posted
- 10 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background and Objectives Hospital at Home (HaH) delivers hospital-level treatment to acutely ill patients in their own homes, including daily medical and nursing visits, infusions, physiotherapy, and diagnostics. It bridges inpatient and outpatient care, working closely with hospitals, office-based physicians, home care services (Spitex), and therapy providers.
There are two main pathways:
Admission Avoidance: stable patients requiring hospitalization are admitted directly to HaH instead of an inpatient ward.
Early Supported Discharge: patients treated in hospital are discharged earlier than usual and transferred to HaH.
Evidence International studies show HaH to be safe and effective. Reviews report comparable mortality and rehospitalization, shorter hospital stays, and cost advantages. Admission avoidance is linked to trends toward lower mortality and costs. Research showed similar mortality but fewer rehospitalizations, longer treatment duration, and reduced risks of institutionalization, depression, and anxiety. HaH patients were older, with reduced daily living activities, yet care costs were on average USD 5,054 lower than inpatient care.
In Switzerland, the mean hospital stay in 2019 was 8 days (acute somatic: 5.2; psychiatry: 33.5).
Study Hypotheses
HaH can be delivered at equal or lower cost than regular hospitalization.
HaH care is safe, with few complications, and yields high patient satisfaction.
Study Objective To demonstrate that hospital-equivalent home treatment of acutely ill patients is effective, appropriate, cost-efficient (according to Swiss WZW criteria), safe, and associated with high satisfaction and low complication rates compared with inpatient care.
Endpoints
Primary: Costs - HaH vs. inpatient care at Hirslanden Clinic, using REKOLE® cost accounting.
Secondary: Mortality, therapy type, monitoring, diagnostics, rehospitalization, complications, satisfaction, patient-reported outcomes, length of stay, referrals to nursing homes, follow-up after discharge, ED visits, rehabilitation referrals, and home care type.
Detailed description
- BACKGROUND AND SIGNIFICANCE OF THE STUDY The Hospital at Home concept enables hospital-equivalent treatment of acutely ill patients requiring hospitalization in their own homes. Treatment is carried out as in a regular hospital, with daily visits by physicians and nurses. In addition to disease management, including infusion therapies, home-based physiotherapy and diagnostic procedures such as blood and urine testing, ultrasound, and electrocardiography are provided. This positions Hospital at Home at the interface between traditional inpatient and outpatient care, complementing the existing services of hospitals, office-based physicians, home care organizations (Spitex), physiotherapy, and occupational therapy through a structured treatment process at the patient's home. Care is not provided in isolation but in cooperation with the aforementioned established institutions. Two referral pathways into Hospital at Home can be distinguished: Admission Avoidance: eligible patients in stable general condition with an acute illness that would normally require hospitalization are admitted directly into Hospital at Home instead of inpatient care and treated equivalently at home. Early Supported Discharge: patients already treated in a regular hospital and in good general condition are discharged earlier than usual and transferred to Hospital at Home, where treatment is completed. Hospital at Home has been investigated in various international studies. A review found, patients assigned to Hospital at Home via early supported discharge showed comparable mortality and rehospitalization rates and shorter hospital stays. Patients admitted via admission avoidance showed a trend towards lower mortality and costs and comparable rehospitalization rates. Further research found similar mortality rates between Hospital at Home and regular inpatients, but lower rehospitalization rates and longer treatment durations in the Hospital at Home group. It also showed lower risk of institutionalization in long-term care facilities, as well as a reduced risk of depression and anxiety. A retrospective observational study from New York, USA, showed, that Hospital at Home patients were on average older and showed reduced activities of daily living. The costs of Hospital at Home care were on average USD 5054 lower than those of comparable inpatients. In Switzerland in 2019, the average length of stay across all hospital sectors was 8.0 days, with the shortest in acute somatic care (5.2 days) and the longest in psychiatry (33.5 days).
- PROJECT OBJECTIVES AND DESIGN 2.1 Hypotheses and Primary Study Objective
Hypothesis 1 Care through Hospital at Home can be delivered at equivalent or lower cost compared to regular hospitalization.
Hypothesis 2 Hospital at Home care is safe for patients, associated with few complications, and yields high patient satisfaction.
Study Objective Our study aims to demonstrate that hospital-equivalent treatment of acutely ill patients at home is effective, appropriate, and cost-efficient (according to the Swiss WZW criteria) and, compared with regular inpatient care, is safe, associated with low complication rates, and achieves high patient satisfaction.
2.2 Primary and Secondary Endpoints
Primary Endpoint:
Costs: Treatment in Hospital at Home can be cost-equivalent or more cost-effective compared to regular inpatient care. Patient data from Hospital at Home AG will be compared with patient data from regular inpatients at Hirslanden Clinic. Costs, or billable tariffs, will be considered based on cost accounting according to REKOLE®.
Secondary Endpoints (as defined in section 3.3 "Additional Study Variables"):
Mortality
Type of therapy
Type of monitoring
Type and frequency of diagnostics
Rehospitalization during and after treatment
Complications and complication rates
Patient satisfaction
Patient-related outcomes
Length of stay
Referrals to nursing homes or long-term care after discharge
Follow-up with general practitioner or specialist after discharge
Emergency department visits during treatment and after discharge
Referral to rehabilitation clinics after discharge
Type of home care after discharge
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Target follow-up
- 1 Day
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Hospital at Home Group | – | –100 participants treated in hospital at home |
| Regular hospital group/"Brick and mortar group" | – | –100 participants treated in the hospital |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- 200 participants total, 100 from the regular hospital ("brick and mortar"), 100 from Hospital at Home. Patients from 18years of age upwards with a disease treated in the hospital or in hospital at home.
Key inclusion criteria (5 listed)
- Inpatients in the hospital or patients in Hospital at Home care
- Age ≥ 18 years
- Admission due to a typical Hospital at Home diagnosis (mild to moderate inflammatory and infectious diseases of the lungs, urinary tract, gastrointestinal tract, heart, and skin; exacerbated chronic obstructive pulmonary disease; exacerbation of chronic heart failure; wounds; bleeding/anemia; dehydration; deterioration of general condition in multimorbid patients; infection-related complications in oncological patients; psychiatric problems including delirium; metabolic or autoimmune diseases; orthopedic patients; pain exacerbations of any cause; palliative patients up to and including terminal situations)
- Patients without severe cognitive impairment or dysfunction who are capable of providing informed consent and/or completing the questionnaire
- Patients with sufficient proficiency in written and spoken German and/or English
Key exclusion criteria (2 listed)
- Inpatient admission for other reasons
- Refusal to provide informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Costs
Time frame: 1 year or until the total of 200 participants are included
Comparison of cost of treatment in Hospital at Home vs. regular hospital ("brick and mortar"). Data will be collected via financal data of both groups, 100 patients from the regular hospital (Klinik Hirslanden Zurich) and 100 patients from Hospital at Home AG (Zollikon)
3 secondary outcomes
Effectiveness (clinical outcome)
Time frame: 1 year or until the total of 200 participants are included
Effectivness (complications)
Time frame: 1 year or until the total of 200 participants are included
Patient satisfaction
Time frame: 1 year or until the total of 200 participants are included
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Dec 2025.
- Results publication: PubMed 33514582Leong MQ, Lim CW, Lai YF. Comparison of Hospital-at-Home models: a systematic review of reviews. BMJ Open. 2021 Jan 29;11(1):e043285. doi: 10.1136/bmjopen-2020-043285.
- Individual participant dataSharing planned: Undecided. Would be interesting to compare data with other Hospital at Home programs, but no plans are yet made.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Costs and Cost Analysis and Effectiveness, run by Hospital at Home AG at 1 site in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 10 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Kilian Braendle, Dr. med. (+41444553304, kilian.braendle@hospitalathome.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Costs (time frame: 1 year or until the total of 200 participants are included). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07274072, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Dec 2025.