Ministry of Health: Home Hospitalization Replaces 12% of Israel Inpatient Care
A Ministry of Health report reveals Israeli home hospitalizations grew from 136 in 2018 to 38,000 in 2024, replacing 12% of internal medicine ward stays. However, severe funding uncertainty and geographic disparities persist.
The Rapid Rise of Home Hospitalization
Home hospitalization in Israel, considered an experimental and negligible service until just a few years ago, has rapidly become a significant component of the country's inpatient care system. This is according to a special report published today (Sunday) by the Ministry of Health, which maps the comprehensive development of the service for the first time.
In 2018, only 136 home hospitalizations were recorded in Israel. By 2024, that number soared to approximately 38,000, representing 3.9 hospitalizations per 1,000 residents. In total, about 115,000 home hospitalizations were conducted between 2018 and 2024.
The most significant figure is the share of this service within the internal medicine departments. In 2024, home hospitalizations accounted for approximately 12% of all admissions in the monitored internal medicine frameworks and about 11% of their total hospitalization days. In other words, more than a tenth of the inpatient activity traditionally performed in internal medicine wards has been transferred to the patient's home.
In terms of capacity, this represents a substantial operation. In 2024, an average of 445 patients were in home hospitalization at any given moment. During the peak month, the number reached approximately 600 concurrent patients—a capacity equivalent, according to the Ministry of Health, to about 17 internal medicine departments. For comparison, all general and geriatric internal medicine departments in Israel had 4,314 standard beds in 2024, meaning home hospitalization is equivalent on average to a tenth of their physical capacity, and up to 14% at peak times.
Driven by Hospital Bed Shortages
The expansion of the service comes against the backdrop of a prolonged erosion in the number of hospital beds relative to the population. Between 2014 and 2024, only about 170 beds were added to internal medicine departments—a cumulative increase of just 4%. During the same period, the rate of beds per 1,000 residents dropped from 0.50 to 0.44, a 12% decrease. Among those aged 65 and older, the erosion is even more severe: the number of beds per 1,000 older adults fell from 4.7 to 3.4, a decline of approximately 27%.
The report also indicates that the expansion of home hospitalization does not necessarily generate a new wave of admissions. The total number of hospitalizations in internal medicine frameworks rose to about 325,000 in 2023–2024, compared to about 287,000 on the eve of the pandemic. However, after adjusting for population growth, the increase is much more moderate. In 2024, 33.3 hospitalizations per 1,000 residents were recorded, only 1.6 more than in 2019, while home hospitalizations alone accounted for 3.9 hospitalizations per 1,000 residents. This data supports the assessment that a significant portion of home hospitalizations replaces institutional hospitalization rather than adding to it.
The target population is primarily elderly: 73% of those hospitalized at home between 2021 and 2024 were aged 65 and older, and 56% were aged 75 and older. The median age was 77. The most common diagnoses were pneumonia, urinary tract infections, cellulitis, dehydration, and heart failure.
Geographic Disparities and Budgetary Uncertainty
However, the service is not distributed equally from a geographical perspective. Overall, the periphery does not lag far behind the center: in peripheral clusters 1–4, the rate of home hospitalization in 2024 stood at 3.5 per 1,000 residents, compared to the national average of 3.9. Among those aged 65 and older, the rate was even higher than average—24.2 compared to 21.4 per 1,000.
Yet, a deeper breakdown—separating clusters 1–2 from clusters 3–4—reveals a sharp disparity. In clusters 3–4, which are less peripheral, the rate of home hospitalization among those aged 65 and older stood at 30.4 per 1,000—the highest in Israel. Conversely, in clusters 1–2, which include the most remote localities, it reached only 7.7—about a third of the national average.
Alongside its success, the Ministry of Health warns of a potential slowdown. The number of home hospitalization days reached approximately 162,000 in 2024, but the growth rate has moderated. According to health funds and providers, the slowdown is not due to a shortage of manpower or saturated demand, but mainly due to uncertainty regarding continued budgetary support. The budget for the service is still not anchored in the permanent base of the health funds, and the support pilot for 2025 has been significantly reduced.
