Adapting Hospital in the Home to Climate Change.

Hospital in the home (HITH) services allow patients to return to their home environment where they can continue receiving hospital-level care with nursing and/or medical staff attending a patient’s home to provide care. They have become a key part of delivering acute health services. A common component of most Australian HITH services is giving intravenous antibiotics to patients with infections. Monash Health HITH is Australia’s largest service caring for approximately 18% of the Victorian population. The rapidly changing Australian climate poses unique challenges for HITH programs. As opposed to patients in hospitals who are cared for in an airconditioned building, patients cared for at home may be exposed to much more varied conditions depending on their housing situation. Heat can have many direct and indirect impacts on health. Those with comorbidities have increased vulnerability to heat through a direct effect on body physiology, as well as impacting the effect of medications. Medication effectiveness may also be impacted when used outside optimal temperature conditions. This is a world-first research program studying whether patients receiving parenteral antimicrobials or other therapy for chronic disease at home through a HITH program may be exposed to temperatures that are detrimental to their treatment or overall health state. The research program will involve a clinical study measuring the temperature and comfort of HITH patients’ home environment and their physiological response to heat exposure whilst at home. Financial support is available for conferences and other activities during the year.