Satisfaction with hospital at home care.
OBJECTIVE
To examine differences in satisfaction with acute care between patients who received treatment in a physician-led substitutive Hospital at Home program and those who received usual acute hospital care.


METHODS
Survey questionnaire of participants in prospective, nonrandomized clinical trial.


METHODS
Three Medicare-managed care health systems and a Department of Veterans Affairs Medical Center.


METHODS
Two hundred fourteen community-dwelling elderly patients who required acute hospital admission for community-acquired pneumonia, exacerbation of chronic heart failure, exacerbation of chronic obstructive pulmonary disease, or cellulitis, 84 of whom were treated in Hospital at Home and 130 in the acute care hospital.


METHODS
Treatment in a Hospital at Home model of care that substitutes for treatment in an acute care hospital.


METHODS
A 40-question survey measuring nine domains of care for patients and a 37-question survey measuring eight domains of care for family members.


RESULTS
A higher proportion of patients were satisfied with treatment in Hospital at Home than with the acute care hospital in eight of nine domains, and this difference was statistically different in four domains. Hospital at Home patients were more likely than acute hospital patients to be satisfied with their physician (adjusted odds ratio (AOR) = 3.84, 95% confidence interval (CI) = 1.32-11.19), comfort and convenience of care (AOR = 6.52, 95% CI = 1.97-21.56), admission processes (AOR = 5.90, 95% CI = 2.21-5.76), and the overall care experience (AOR = 2.98, 95% CI = 1.08-8.21). Family members of patients treated in Hospital at Home were also more likely to be satisfied with multiple domains of care.


CONCLUSIONS
Hospital at Home care was associated with greater satisfaction than acute hospital inpatient care for patients and their family members. These findings support further dissemination of the Hospital at Home care model.
Leff
Bruce
B
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. bleff@jhmi.edu
Burton
Lynda
L
Mader
Scott
S
Naughton
Bruce
B
Burl
Jeffrey
J
Clark
Rebecca
R
Greenough
William B
WB
Guido
Susan
S
Steinwachs
Donald
D
Burton
John R
JR
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D002481:Cellulitis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006333:Heart Failure / Q000628:therapy; D018575:Home Care Services, Hospital-Based; D006760:Hospitalization; D006801:Humans; D008171:Lung Diseases / Q000628:therapy; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome