Direct Home Hospitalisation for Patients with Acute Heart Failure from Emergency Departments

Acute decompensated heart failure (ADHF) is a major public health challenge, particularly in ageing populations, contributing to increased hospital admissions and healthcare costs. Coronary artery disease and hypertension are key drivers of heart failure, underscoring the need for improved management strategies.

This study investigates the feasibility of direct home hospitalisation as an alternative to inpatient care for ADHF patients presenting to emergency departments (EDs) in Singapore. Current care pathways, including admissions to ICUs or medical wards, carry risks of longer hospital stays, higher costs, and potential readmissions. Home hospitalisation offers a promising, cost-effective model that provides medical care in the patient’s home and potentially reduces hospital burdens.

The project is structured in four stages. First, a meta-analysis will examine the outcomes of different ADHF dispositions in ED. Second, existing guidelines will be reviewed and updated to enhance decision-making for ADHF patients. Third, a novel AI-based risk stratification tool will be developed to assist ED staff in identifying patients suitable for home care. Finally, a home hospitalisation care model tailored to Singapore’s healthcare system will be designed and piloted. The results will inform national guidelines and offer insights for applying similar models to other acute conditions.