David Levine talks about hospital at home and health equity

Doctors and leaders say hospital-at-home programs offer a chance to improve health equity.

David Levine of Mass General Brigham talks about his system’s work to help patients who have challenges in their home environment. He’s the clinical director of research and development for Mass General Brigham’s “Healthcare at Home” program. Mass General Brigham has provided hospital-level care in patient’s homes for more than eight years.

• Read more: Hospital at home: A special report

“I think considerations for health equity are paramount in home hospital care,” he says. “And our program, and I know many programs across the country, have taken this very seriously and put in real service offerings to make sure that health equity is top of mind, and being sure that we're able to treat all sorts of patients at home.”

Mass General Brigham has helped patients get enrolled in programs offering assistance with housing needs. For patients in public housing with issues such as leaky windows or holes in the floor, the health system will push the landlord or superintendent to make necessary repairs.

“We bring an element of a power dynamic with us, when there's a doctor or a nurse in somebody's home,” Levine says.

Levine and others say by treating patients in the home, clinicians can see other challenges such as food insecurity, or issues patients may be reluctant to discuss in the hospital.

“I think there's a real opportunity and responsibility to address some of the social determinants of health that we see when we're working closely with our patients in their homes," Levine said.