Realweighttraining.com

A new pilot program allowed people who would normally be hospitalized to stay home. Getty Images

• A new study found that the home hospital model can potentially improve care while reducing costs.
• The cost of care was nearly 40 percent lower.
  Trial participants receiving hospital care in their homes had a 70 percent lower rate of readmission to the hospital.
• People check into the hospital expecting to get better, but there are risks — and some even wind up getting sicker.

You can face the danger of complications, like bleeding or infection. There are also the constant check-ins from nurses or physicians that can disrupt sleep.

And none of that includes the cost.

Additionally, when in a hospital, people are stuck in their hospital beds and many experience negative health impacts from this physical inactivity.

However, a pilot study by investigators at Brigham and Women’s Hospital in Boston finds that the home hospital model can potentially improve care while reducing costs. The findings were published in Annals of Internal MedicineTrusted Source today.
“Hospital at Home (HaH) as the name states, cares for hospital-eligible patients at home. Models vary, but generally patients seen in the emergency room that require hospital-level care are given the option of intensive care at home,” said Thomas Cornwell, MD, founder of Northwestern Medicine HomeCare Physicians and chief executive officer, Home Centered Care Institute (HCCI).

First study of its kind

“To date, there has not yet been a randomized controlled trial of home hospital care performed in the U.S. other than our small pilot,” David Levine, MD, MPH, MA, the study’s corresponding author, told Healthline.

The results of Dr. Levine and team’s randomized controlled trial (RCT) can strengthen the case for home hospital care, showing that it reduces costs and readmissions while increasing physical activity compared with usual hospital care.

“We wanted to show with a very high level of evidence that home hospital care could be delivered to acutely ill adults with lower cost, better physical activity, high quality and safety, and excellent patient experience,” said Dr. Levine.

“In addition, we feel this gives all Americans the information they need to choose the care for themselves and their loved ones should they need hospitalization,” he said.

Cost of care was nearly 40 percent lower

Levine and team enrolled 91 adult patients into the trial.

Each participant had been admitted via the emergency department at Brigham and Women’s Hospital or Brigham and Women’s Faulkner Hospital with acute conditions that included infection, worsening heart failure, worsening chronic obstructive pulmonary disease (COPD), and asthma, that lived within 5 miles of the hospital.

They were randomized either to stay at the hospital for standard care or to receive care at home, including nurse and physician visits, intravenous (IV) medications, remote monitoring, video communication, and point-of-care testing.

Researchers measured the total direct cost of care, including costs for nonphysician labor, supplies, tests, and medications.

The findings indicate that patients receiving at-home care had total costs that were almost 40 percent lower than for patients treated conventionally.

“This study shows better outcomes for a lower cost in addition to a better use of resources. This is promising work and more and more attention is being paid to hospital care at home,” said Melissa O’Connor, PhD, MBA, RN, FGSA, and director, Geriatric Interest Group, Villanova University, M. Louise Fitzpatrick College of Nursing.

“However, further work is needed to determine the type of patient this best works for related to their severity of illness,” she said. “Do they need a caregiver? Do they need to be cognitively intact? What type of home environment is required?”

70 percent lower readmission rate

According to the study, those at home had fewer lab orders, less imaging (like X-ray and MRI), and had fewer consultations.

Levine and team also found that home hospital patients were less sedentary, and even had lower readmission rates within 30 days than patients admitted to hospital care.

“We also know that patients move more during a home hospitalization, which we believe goes a long way toward healing,” said Dr. Levine.

The study was actually stopped early on due to the strength of these findings.

“We didn’t build our home hospital study as a readmission reduction program, but one of the more surprising findings was how impactful home hospital care was on 30-day readmission,” said Levine. “Seven percent of home hospital patients, compared to 23 percent of traditional hospital patients, were readmitted at 30 days — nearly a 70 percent reduction!”

Home care is a tailored experience — but who pays?
“Receiving care at home makes for a truly tailored experience,” emphasized Dr. Levine. “The answers to questions such as, ‘which medicines are you taking,’ or ‘what do you need help with during a typical day,’ and ‘what’s in your kitchen’ are easily discussed only when at home and have profound health and healing effects.”

But Dr. Cornwell remarked that Medicare and Medicaid won’t adequately cover the costs of hospital at home.

“There is not a separate fee-for-service payment for HaH. There are no specific codes for it. You would need to use the current house call codes which do not cover all the expense,” Dr. Cornwell said.

“It would be like charging a day in the hospital with an office visit code. Right now, those participating are systems that have at-risk contracts. Because they are on the hook for all medical costs, they benefit from the lower costs of HaH and the better outcomes and patient satisfaction,” he continued.

The bottom line

There are disadvantages to in-hospital care that can increase health risks, but a new clinical trial finds that providing hospital quality care in the home may reduce these risks and improve patient outcomes.

Trial participants receiving hospital care in their homes had a 70 percent lower rate of readmission to the hospital.

Although at-home care can reduce hospital costs and improve patient health, many health insurance providers, especially Medicare and Medicaid, still won’t cover the cost of home-based hospital care.

It took scientists 20 years to develop the Cosmic Crisp, a cross between the Honeycrisp and Enterprise apples. Getty Images

1. A new crossbreed apple called the Cosmic Crisp is headed to store shelves.
2. Experts say the apple can stay fresh for up to a year in your refrigerator.
3. Nutritionists say the apple has a sweet and crisp taste.
4. They say apples are a healthy snack, containing vitamin C and antioxidants.
5. A new breed of apple that stays fresh in your refrigerator for a year has arrived.

The bigger question for consumers, however, might be whether the apples are tasty and healthy.

The Cosmic Crisp is a crossbreed between the flavorful Honeycrisp and the longer-lasting Enterprise apple varieties. It was developed by a team of cultivators at Washington State University in 1997.

More than two decades later, the mature apple trees exclusive to Washington are now slated to make waves in the world market.

The apples, in fact, are a point of pride in the Pacific Northwest state.

“About 20 percent of the world’s apples are out of China, so we’re trying to bring back that expertise,” Roger A. Clemens, PhD, adjunct professor at the University of Southern California School of Pharmacy and member of the American Society for Nutrition, told Healthline.

“The Cosmic Crisp will provide a huge economic boom, not only for the state of Washington but for the United States,” he said. “It helps reduce post-harvest food loss.”
It may also reduce consumer food waste because it lasts longer.

How do they taste?

The Cosmic Crisp, according to its developers and consumer experts, is sweet, crisp, and versatile.

“The first characteristic that stood out to me is the high sugar content,” said Meg Raines, chef at The Evolving Plate, in an online review.

She said the new breed is suited to eating raw as well as roasting, sauteing, and baking.

“The juiciness brings moisture to a baked good and adds liquid to pies, which gets turned into sweet syrup during baking,” said Raines. “This brought a lot of natural sweetness to baked goods, allowing for a reduction of the sugar in the recipe.”

Along with naturally high sugar content, the apple’s texture was developed to meet consumer demands.

“The flesh of the apple is not too dense and dry, but not too watery and mushy either, so it strikes a perfect balance for baking particularly,” stated Raines.

Nearly 90 percent of people in the workplace say they’re unsure how much or what kind of emotional support to offer a co-worker who’s living with a chronic condition. Getty Images

• A new survey from Cancer and Careers found that 88 percent of people have concerns about their ability to support a co-worker with a serious medical condition.
• And 89 percent believe management could have created and fostered a more supportive work environment for colleagues with chronic illness.
• Experts say companies can improve support for employees with chronic conditions by raising awareness and properly training leaders as well as other employees.

When a colleague becomes chronically or seriously ill, it can be difficult to know what to say and do.

“It’s so hard with a co-worker to know what to do when something like this happens even if you lived it before, and it’s so easy — in a totally unintentional way — to say or do the wrong thing or think you’re doing the right thing, but you’re actually adding pressure to the person,” Rebecca Nellis, executive director of Cancer and Careers, told Healthline.

The nonprofit Nellis works for is dedicated to empowering people with cancer to thrive in their workplace.

The organization recently conducted a survey of 1,000 American working adults, and discovered that 88 percent of respondents have concerns about their ability to support a co-worker with a serious medical condition.

The most common concerns reported included:

1. how much or what kind of emotional support to offer
2. how much to ask about their co-worker’s medical condition or status
3. what kind of work-related help to offer

“Clearly, there’s a gap between the needs of those with chronic illness in the workplace and the support being provided by co-workers and management — and much of it’s due to a lack of awareness and training,” Lynn Taylor, workplace expert and author of “Tame Your Terrible Office Tyrant: How to Manage Childish Boss Behavior and Thrive in Your Job,” told Healthline.

Taylor and Nellis say the following are ways to support your co-worker.

Show empathy

Simply telling your co-worker you’re thinking of them is a good start, said Nellis.

“It’s okay to say, ‘I don’t know what to say right now, but I am here and thinking about you’ or ‘I want to be here for you and I want to think about some things that I can offer that might make your life easier right now,’” said Nellis.

She added that one thing people should not say is “I can’t believe you didn’t tell me sooner,” because this will make your co-worker feel guilty rather than cared for.

Let them guide you

Taylor advised to try and be aware of when a co-worker wants their privacy and when they want to talk about their condition.

“Gauge your approach based on their reactions,” she said.

Nellis agreed, and said people should be cautious when sharing stories about other people you know who’ve had the same condition until you understand whether the person is open to hearing them or not.

“If you don’t know the person’s preferences yet, saying, ‘I know it’s going to be okay’ or ‘The same thing happened to someone I know and now they’re running marathons,’ might be well intended, but not be where the person is if they are feeling like things aren’t going to be okay,” said Nellis.

Though the benefits can vary widely from person to person, taking a monthlong break from alcohol can do your body good. Getty Images

1. Cutting out alcohol if you drink in excess can bring about health benefits for your liver, heart, and body composition.
2. The current Dietary Guidelines for Americans recommend that alcohol should be consumed in moderation — up to one drink per day for women and up to two drinks per day for men.
3. Alcohol consumption has been linked to cancers of the head, neck, esophagus, liver, breast, colon, and rectum.

Many people turn to Dry January as a motivator to start off the new year alcohol-free.

But while abstaining from alcohol for a month might seem like a trendy, short-term New Year’s resolution, there are several health benefits that come with it.

“The benefits can vary from person to person depending on how much of a change from their baseline behavior this is,” Dr. Rekha B. Kumar, medical director of the American Board of Obesity Medicine, told Healthline.

Kumar explained that someone who drinks minimally, but chooses to do Dry January, “might feel a sense of control over their health or feel a sense of accomplishment from achieving a set goal.” Meanwhile, others who drink heavily “might notice more pronounced physiologic effects, such as more mental clarity, better sleep, weight loss, and feeling the ‘detox’ sensation, in addition to achieving a set goal.”

Amitava Dasgupta, PhD, professor of pathology and laboratory medicine at McGovern Medical School at UTHealth in Houston, and author of the book The Science of Drinking, agrees.

Dr. Dasgupta said for social and moderate drinkers, participating in Dry January won’t make much difference to their body. However, for people who exceed recommendations in the Dietary Guidelines for AmericansTrusted Source, he said Dry January can reap changes.

The guidelines state that alcohol should be consumed in moderation — up to one drink per day for women and up to two drinks per day for men.

“Studies show that even if you drink in excess once a month, it increases the risk of cardiovascular disease and stroke,” said Dasgupta. “My warning is not for the people who drink in moderation. It’s for the people who drink too much.”