Contact email

dmlevine@partners.org

Overview

This study is the first qualitative study of home hospital care and suggests that patients who receive home hospital care have fewer negative experiences with the clinical team, more factors that promote healing, and fewer systemic logical hurdles.

Department

Medicine

Division

General Internal Medicine

Collaborators

David M. Levine
Julia Pian
Karthiyayini Mahendrakumar
Agustina Saenz
Jeffrey L. Schnipper

Status/Stage of Development

Completed

Measurement

Semi-structured interviews about the patient experience of hospital level care at home during a randomized controlled trial.

Results

-15 home patients and 13 control patients were interviewed
-Patient experience clustered around clinician factors, factors that promoted healing, and systems factors
-The home group had fewer negative comments regarding interactions with physicians, nurses, and aids
-The home group described more factors that promote healing such as improved sleep, increased physical activity, improved social support from family, and better environmental comfort
-Control patients described more difficulties during their admission from the ED to the floor, more negative experiences with technology (e.g., alarms from monitors), and more logistical difficulties in receiving care during their admission (e.g., roommates)
-Both groups noted difficulties with the discharge process and carrying out care plan after discharge

National/Policy Context

Substitutive hospital level care in patient’s homes has been shown to reduce costs, lower readmission rates, and reduce utilization.

Sources

David M. Levine, Julia Pian, Karthiyayini Mahendrakumar, Agustina Saenz, Jeffrey L. Schnipper. Hospital-Level Care at Home for Acutely Ill Adults: A Qualitative Evaluation of a Randomized Controlled Trial [abstract]. In: SGIM Annual Meeting 2019.;May 8-May 11; Washington D.C.