Contextual Interaction with Patient and Caregiver Factors for Hospital-at-Home program Engagement
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
Hospital at Home (HaH) is an alternative model of care, where patients who would otherwise be hospitalized are transferred home with hospital care to be carried out in the home environment. Caregivers are central to HaH programs as many patient care tasks shift from hospital personnel to in-home informal caregivers.
Objective
To describe the experiences of patients and caregivers, identify factors affecting care delivery, and identify potential patient and caregiver factors serving as barriers and facilitators to engage in a HaH program.
Study Setting and Design
The study was conducted in a large , academic center in the Southeastern US.
Data Sources and Analytic Sample
This qualitative study enrolled a purposive sample of English-speaking patients who received treatment at home and with caregivers of patients who had received HaH services. The Qualitative Research Core conducted 30 to 60 minutes interviews using semi-structured interview guides for patients and caregivers. A total of twenty-three interviews were conducted.
Principal Findings
A conceptual framework was developed indicating an interaction between patient/caregiver-level factors (e.g., program attitudes and beliefs) with factors in the broader HaH program context (e.g., provider experience). Modifying factors (e.g., past experiences with hospitalization) affected patient and caregivers’ willingness to engage in the HaH program.
Conclusions
Patients and caregivers are willing to engage in HaH but their willingness is affected by factors in the broader caregiving context and person-level factors. Their experience with previous hospitalizations and the COVID-19 pandemic affected their willingness to engage.
