Sustaining Health Outside of Hospitals: Home Infusion Therapy for Value-Based Long Term Care

Home infusion therapy (HIT) is a value-based healthcare delivery model where patients receive intravenous medications with home health services (HHS) outside the hospital. Our objective was to provide a comprehensive review of HIT services, tracing its historical development and examining its current role as a critical component of healthcare delivery worldwide. We evaluated peer-reviewed papers and online resources on HIT and HHS, published in English from 1959 to May 2025. Our review supports HIT services globally for three reasons: advance long-term care for the aging population, decrease antimicrobial resistance, and improve healthcare affordability, efficiency and access with continuation of post-acute complex care. The US has pioneered and dominated this field of HIT since 1970’s, providing affordable, safe, effective and convenient services to patients, especially those requiring long-term care. While Canada, Europe, and Australia have offered HIT services, many other countries, including low- and middle-income countries (LMICs), provide limited to absent HIT services due to lack of regulations, experience, knowledge and training. HIT is viewed as a cost-effective alternative to hospital care, and payers have generally accepted higher home-based charges as long as they remain below inpatient costs. The strategic roadmap to safe and cost-effective HIT implementation must include provisions for a robust regulatory framework; competitive reimbursement structures to foster scalability; accreditation and certification standards to ensure patient safety; and access with modern technologies and digital transformation. Both HIT and HHS offer a safe, effective, and economical alternative to inpatient care. Policy reforms that initiate or expand coverage and streamline provider entry can strengthen this growing industry while improving patient outcomes and system-wide efficiency. KEYWORDS: Outpatient parenteral antibiotic therapy, antibiotic resistance, home infusion therapy, global health