Abstract
Introduction: Hospital-at-Home (HaH) programmes are well-established in Australia, Europe, and the United States. However, there is limited experience in Asia, where the hospital is traditionally seen as a safe and trusted space for healing. This cross-sectional study aimed to explore attitudes and perceptions among patients and caregivers in Singapore toward this care model.Methods: A quantitative study design was adopted to collect data among patients and their caregivers from medical wards within two acute hospitals in Singapore. Using a series of closed-ended and open-ended questions, the investigator-administered survey aimed to explore barriers and facilitators determining patients' and caregivers' responses. The study questionnaire was pretested and validated. Data were summarised using descriptive statistics, and logistic regression was performed to determine key factors influencing patients' decisions to enrol in such programmes.Results: Survey responses were collected from 120 participants (101 patients, 19 caregivers; response rate: 76%), of which 87 respondents (72.5%) expressed willingness to try HaH if offered. Many respondents valued non-quantifiable programme benefits, including perceived gains in quality of life. Among them, reasons cited for acceptance included preference for the comfort of their home environment, presence of family members, and confidence toward remote monitoring modalities. Among respondents who were unwilling to accept HaH, a common reason indicated was stronger confidence toward hospital care.Discussion: Most patients surveyed were open to having acute care delivered in their home environment, and concerns expressed may largely be addressed by operational considerations. The findings provide useful insights toward the planning of HaH programmes in Singapore.
Highlights
Hospital-at-Home (HaH) programmes are well-established in Australia, Europe, and the United States
In HaH care model, remote monitoring and telecommunication technologies can be used to enable the delivery of hospital-level care, which include physician consultations, medication administration, nursing, and therapy services, clinical diagnostics, and investigations, etc
Among the 120 respondents, 87 (72.5%) expressed acceptance toward the novel care model (Figure 1); 29 (28.7%) and 45 (44.6%) patients indicated their definite and probable willingness to participate in a HaH programme, respectively, and (21.1%) and 9 (47.4%) caregivers reported definite and Demographic and clinical variables Observations (n = 92)
Summary
Hospital-at-Home (HaH) programmes are well-established in Australia, Europe, and the United States. HaH models have been implemented in countries such as Australia, the United States, Canada, the United Kingdom, and Spain [2] This model of care was implemented as a possible solution to various issues associated with delivery healthcare in hospital. Studies have shown that the implementation of HaH can result in improved clinical outcomes, in terms of a shorter length of stay and reduced readmission rates [6, 7]. It may bring about greater patient and caregiver satisfaction, along with cost savings for both the patients and the healthcare system [7,8,9]. HaH has been found to reduce mental stress and adverse hospital events such as functional decline, incontinence, and delirium experienced by elderly who undergo acute hospital admissions [5]
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