tetano
Editor, Senior Moderator
J Patient Exp
. 2023 Aug 7;10:23743735231189354.
doi: 10.1177/23743735231189354. eCollection 2023. Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study
Nels Paulson[SUP] 1 [/SUP], Margaret P Paulson[SUP] 2 [/SUP], Michael J Maniaci[SUP] 3 [/SUP], Rachel A Rutledge[SUP] 4 [/SUP], Shealeigh Inselman[SUP] 5 [/SUP], Stephanie J Zawada[SUP] 6 [/SUP]
Affiliations
To understand why US patients refused participation in hospital-at-home (H@H) during the coronavirus disease 2019 Public Health Emergency, eligible adult patients seen at 2 Mayo Clinic sites, Mayo Clinic Health System-Northwest Wisconsin region (NWWI) and Mayo Clinic Florida (MCF), from August 2021 through March 2022, were invited to participate in a convergent-parallel study. Quantitative associations between H@H participation status and patient baseline data at hospital admission were investigated. H@H patients were more likely to have a Mayo Clinic patient portal at baseline (P-value: .014), indicating a familiarity with telehealth. Patients who refused were more likely to be from NWWI (P-value < .001) and have a higher Epic Deterioration Index score (P-value: .004). The groups also had different quarters (in terms of fiscal calendar) of admission (P-value: .040). Analyzing qualitative interviews (n = 13) about refusal reasons, 2 themes portraying the quantitative associations emerged: lack of clarity about H@H and perceived domestic challenges. To improve access to H@H and increase patient recruitment, improved education about the dynamics of H@H, for both hospital staff and patients, and inclusive strategies for navigating domestic barriers and diagnostic challenges are needed.
Keywords: home hospitalization; hospital-at-home; patient preferences; remote care.
. 2023 Aug 7;10:23743735231189354.
doi: 10.1177/23743735231189354. eCollection 2023. Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study
Nels Paulson[SUP] 1 [/SUP], Margaret P Paulson[SUP] 2 [/SUP], Michael J Maniaci[SUP] 3 [/SUP], Rachel A Rutledge[SUP] 4 [/SUP], Shealeigh Inselman[SUP] 5 [/SUP], Stephanie J Zawada[SUP] 6 [/SUP]
Affiliations
- PMID: 37560532
- PMCID: PMC10408328
- DOI: 10.1177/23743735231189354
To understand why US patients refused participation in hospital-at-home (H@H) during the coronavirus disease 2019 Public Health Emergency, eligible adult patients seen at 2 Mayo Clinic sites, Mayo Clinic Health System-Northwest Wisconsin region (NWWI) and Mayo Clinic Florida (MCF), from August 2021 through March 2022, were invited to participate in a convergent-parallel study. Quantitative associations between H@H participation status and patient baseline data at hospital admission were investigated. H@H patients were more likely to have a Mayo Clinic patient portal at baseline (P-value: .014), indicating a familiarity with telehealth. Patients who refused were more likely to be from NWWI (P-value < .001) and have a higher Epic Deterioration Index score (P-value: .004). The groups also had different quarters (in terms of fiscal calendar) of admission (P-value: .040). Analyzing qualitative interviews (n = 13) about refusal reasons, 2 themes portraying the quantitative associations emerged: lack of clarity about H@H and perceived domestic challenges. To improve access to H@H and increase patient recruitment, improved education about the dynamics of H@H, for both hospital staff and patients, and inclusive strategies for navigating domestic barriers and diagnostic challenges are needed.
Keywords: home hospitalization; hospital-at-home; patient preferences; remote care.