Published: 29 May 2026
Author(s): David Nicolás, Andrea Parra-Plaza, Ainoa Ugarte
Issue: May 2026
Section: Letter to the Editor

Hospital-at-Home (HaH) programmes are expanding rapidly across European health systems as substitutive acute care models [1,2]. As they consolidate, unplanned transfer back to hospital — termed clinical escalation — has become one of the most widely reported safety metrics in the field [3]. This is appropriate, but the current practice of reporting it as a single, undifferentiated rate may be insufficient and lead to erroneous conclusions.

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