Dutch hospitals discharge patients sooner as remote care expands nationwide

Dutch hospitals are discharging patients earlier and delivering increasing amounts of medical care at home, even for conditions once requiring extended admission, AD reports. The trend, driven by pressure on hospital capacity and growing healthcare demand, is reshaping the way care is delivered in the Netherlands — with both benefits and concerns.

Patients suffering from mild strokes, acute pancreatitis, heart problems, or even severe infections are now spending only one or a few days in the hospital before continuing recovery at home under remote medical supervision. They are monitored via smart sensors, apps, and daily contact with nurses.

The number of hospital admissions is expected to continue falling as care shifts to home settings. The goal is to reserve hospital beds for the most vulnerable patients who truly need inpatient treatment.

Several Dutch hospitals are already reducing inpatient stays significantly. Health insurer VGZ has reported up to 25 percent fewer hospital days and in-person consults at hospitals that actively promote home-based care.

At Isala Hospital in Zwolle, 6,500 hospital days — or 4 percent of the total — are expected to be replaced this year with at-home care. Elisabeth-TweeSteden Hospital in Tilburg saves 4,000 to 5,000 days per year by administering intravenous antibiotics at home. Gelre Ziekenhuizen eliminated around 3,500 inpatient days in 2023 through similar measures.

Remote monitoring is becoming standard in several facilities. At Rijnstate Hospital in Arnhem, patients with mild acute pancreatitis are discharged much sooner than before. Instead of days of inpatient observation, they receive an average of four days of remote hospital care. Nurses call every morning, and patients wear a “smart patch” that tracks breathing and heart rate. “If the values are abnormal, we call them right away,” Katinka Limburg, a specialized nurse at Rijnstate’s virtual care center, told AD. The hospital is conducting scientific research on this approach.

Many patients who once spent weeks in the hospital are now treated at home. Some receive intravenous antibiotics or cancer medication at home. Others, such as those with kidney failure, can reduce the number of hospital visits. Even tests for sleep apnea are now conducted remotely using devices patients take home.

At Isala, patients who arrive at the emergency room with a mild stroke are discharged earlier and monitored remotely for weeks. The same applies to patients with mild heart attacks, pregnant women with severe nausea, and people with infections.

"It’s scary for patients not to be in the hospital, so it’s important to maintain personal contact," Tom Faber, manager of connected care at Isala, told AD. "But this is going to expand rapidly."

While the shift is accelerating, implementation varies across hospitals. “It’s going more slowly than we would like,” Simone van Dulmen, researcher at Radboudumc, told NOS. She noted that some healthcare workers are still adjusting, and home care often depends on doctors who are willing to embrace and trust the new system.

Despite fewer hospital days, healthcare costs have not yet dropped. “It should already be saving millions, but that hasn’t happened,” Peter van der Voort, professor of healthcare at TIAS School for Business and Society, told AD. “Whether a patient stays one or five days, hospitals still receive the same amount. Changes in healthcare take time.”

VGZ acknowledged that early investments are needed before savings appear. The insurer expects costs to decrease over time as more patients participate and systems improve.

Many patients recover faster at home, sleep better, and have a lower risk of infection. But others are anxious about being discharged so quickly. “Traditionally, patients are treated in a hospital, so people assume that’s where they should be,” Tim Engelen, spokesperson for Elisabeth-TweeSteden Hospital, told AD. Some patients reportedly struggle with the technology required for home monitoring, particularly if there is a language barrier.

The Dutch Patients Federation (Patiëntenfederatie Nederland) stresses that communication is critical. “No patient wants to stay in the hospital longer than necessary, but they want to be sure it's safe,” said spokesperson Tijmen Hendriksen. “They also need to know what to do if recovery stalls or their condition worsens. That kind of communication is sometimes lacking.”