Pediatric Hospital at Home: A Scoping Review

CONTEXT: Hospital at Home (HaH) is an acute care model that delivers hospital-level services to the patient's home as a substitute for conventional inpatient admission. Although pediatric HaH programs are well established internationally, the evidence base remains limited. OBJECTIVE: To map the operational characteristics, outcomes, and evidence gaps of pediatric HaH programs. DATA SOURCES: A comprehensive literature search was conducted for studies published between January 1, 2000, and July 25, 2025. STUDY SELECTION: Eligible studies included programs with patients aged 18 years or younger and aligned with the World Hospital at Home Congress definition. DATA EXTRACTION: Data were extracted on study characteristics; implementation, infrastructure, and program design; clinical safety and effectiveness; cost-effectiveness and economic impact; and patient, caregiver, and/or clinician perspectives and experiences. RESULTS: Thirty-four studies met eligibility criteria. Most were observational, with few randomized or nonrandomized controlled studies. Programs varied substantially in admission pathways, staffing, eligibility criteria, monitoring, and clinical populations. Studies demonstrated low escalation and readmission rates, infrequent serious adverse events, high caregiver satisfaction, and generally comparable or lower health care costs relative to conventional inpatient care. Few studies directly evaluated clinical effectiveness, included rigorous economic analysis, or incorporated child and clinician perspectives. LIMITATIONS: The literature was limited by heterogeneous study populations, program designs, outcome reporting, and variable definitions and descriptions of HaH models, introducing potential for misclassification. CONCLUSIONS: Pediatric HaH shows promise as a safe and family-centered alternative to conventional hospitalization, though the existing evidence remains limited and heterogeneous, highlighting the need for more rigorous evaluation.