Outcomes of patients with cancer admitted to a dedicated oncology service within a multisite home hospital program.

Abstract

1504 Background: Home hospital programs deliver acute, inpatient-level care in patients’ homes, and many health systems have adopted these programs after CMS granted a waiver for acute hospital care at home in November 2020. These programs may offer advantages for patients with cancer, including reduced exposure to hospital-associated complications and increased time at home. However, evidence describing outcomes for patients with cancer admitted to home hospital programs remains limited. In March 2025, Mass General Brigham (MGB) launched an oncology service within the system’s multisite home hospital program. Here we describe outcomes among patients with cancer admitted to this service and compared them with outcomes of patients admitted to a brick and mortar (B&M) oncology service. Methods: We conducted a retrospective cohort study of patients with cancer admitted to MGB’s home hospital program between March 1, 2025 and December 31, 2025. Patient demographics, admission diagnosis, length of stay (LOS), the rate of escalations (patients requiring transfer back to a B&M hospital for increased acuity of care), and 30-day readmission rates were collected. Propensity score matching was used to construct a cohort of patients discharged from a B&M oncology service during the year prior to the launch of the home hospital oncology service. Total LOS and 30-day readmission rates were compared between the cohorts using multivariable regression models. Results: There were 137 patients admitted to the home hospital oncology service during the period of analysis. The mean age was 69.7, 53.3% of patients were male, 70.8% were non-Hispanic White, and 87.6% spoke English. The most common admission diagnoses were sepsis (16.1%), skin/soft tissue infections (13.9%), urinary tract infections (10.2%), and renal and electrolyte disorders (10.2%). Twenty patients (14.6%) were admitted directly from an Emergency Department and 85.4% of patients were transferred from inpatient services. The average LOS was 8.9 days, 4.5 days on a B&M service and 4.4 days admitted to home hospital, and the escalation rate was 10.2%. The 30-day readmission rate was 15.8%. When compared to a propensity score matched cohort of patients discharged from a B&M oncology service, the average LOS was not significantly different while the 30-day readmission rate was significantly lower among patients discharged from home hospital. Conclusions: These data show that patients with cancer can be successfully managed in a multisite home hospital program. This dedicated oncology service was able to care for patients with cancer with broad array of admission diagnoses, and the 30-day readmission rate was lower when compared to a cohort of matched patients discharged from a B&M oncology service. Home hospital is a promising model to provide acute care at home for patients with cancer and warrants further study.