Hospital in the Home for Children During the Pandemic and Beyond

The increase in hospital in the home admissions during the pandemic raises the broader question about how much acute pediatric care could be achieved outside of hospital settings, write Associate Professor Penelope Bryant and Dr Laila Ibrahim. Before the coronavirus disease 2019 (COVID-19) pandemic, the management of acutely unwell children at home was increasingly being adopted to realize the well documented quality of life and financial benefits. With the largest pediatric hospital in the home (HITH) program in Australasia, the Royal Children’s Hospital Melbourne already had processes before the pandemic that were applicable to managing COVID-19, including direct referrals from the emergency department (ED), being able to conduct telehealth reviews, and home oximetry.The increase in HITH admissions during the COVID-19 pandemic raises the broader question about how much acute paediatric care could be achieved outside of hospital settings. Based on our findings, we advocate that, where possible, children should be cared for at home rather than hospital, knowing the benefit to quality of life and severe impact on children’s mental health of this pandemic.