The Hospital at Home aims to avoid the many complications, including delirium, which can result from the hospital admission of older patients.  Hospital at Home can provide an alternative setting of care for patients who do not want to be hospitalized or for hospitals facing capacity constraints.

Recognizing that many older adults experience adverse events while hospitalized, Dr. John Burton, at the time the Chief of Geriatrics at Johns Hopkins School of Medicine, and Dr. Donna Regenstreif, former Senior Program Officer at The John A Hartford Foundation conceived of the Hospital at Home as a care model that could provide safe and effective hospital-level care in the home.  A team of geriatric physicians and nurses, led by Dr. Bruce Leff, developed the basic model of Hospital at Home, and an initial study of the concept was conducted at Johns Hopkins Bayview Medical Center in 1999.

To further evaluate the concept, a national demonstration and evaluation study was conducted between 1999-2003 in three Medicare managed care organizations and one Veterans Administration health center.