Oost west, thuis toch echt het best?

This article discusses the outcomes of a randomized controlled trial by Shepperd et al in the UK on comprehensive geriatric assessment and hospital-at-home (HaH) for older adults, compared to hospitalization and the implications for the Dutch health care system. The authors found that older adults have comparable outcomes in terms of living at home and mortality at six months, but older adults were more satisfied with the HaH care, less often experienced a delirium and less older adults were admitted to the nursing home. The hospital-at-home model has some other advantages, as it minimizes transitions, older adults are more active in their own environment and experience more autonomy and self-management. To implement this model in the Netherlands it is important to sharply define the target group for HaH, to have a team with nurse practitioners and geriatrician who is able to provide the care 24/7 and to build an acute geriatric infrastructure in primary care, so the HaH is a serious alternative to hospital care.

Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.