Consumer and Provider Perspectives on Hospital in the Home: A Qualitative Study

Abstract

The delivery of acute health care has changed with the adoption of new technologies to meet changing community needs. In response to this, hospital systems and governments have invested in alternative models of care, including hospital in the home (HITH), where acute care that would typically require inpatient treatment is provided in the patient’s home. The academic literature presents evidence for comparable or improved patient outcomes associated with HITH interventions. However, it is currently unknown how consumers and providers view the model in the context of a new healthcare facility. This study aimed to elicit consumer and provider views about HITH and how the implementation of a HITH model of care in a new hospital could meet their healthcare needs. We adopted a qualitative approach for this research. Semistructured workshops and interviews were conducted via Zoom, where we presented patient vignettes of different models of care to consumers and providers and recorded their responses using scribes. Qualitative data were independently coded by pairs of researchers to identify themes and subthemes, and demographic data were aggregated. A total of 51 consumers and 35 providers attended the workshops. Consumers and providers frequently described similar themes, particularly accessibility, patient factors, and the health system consequences of HITH. However, the importance and focus of these topics varied across participants. Participants endorsed HITH as a flexible, patient-centred model with potential for wellbeing benefits. However, they noted the potential need for additional resources and increased anxiety among patients with lower health literacy. To address this, participants described the need for clear escalation protocols, communication channels, and expectations around HITH care. In conclusion, HITH is an established model that brings acute care into the homes of patients. The findings of this study support the provision of flexible acute care delivery to meet consumer needs and address the challenges encountered during the COVID-19 pandemic.