JMIR Publications

ABSTRACT

Background:

Traditional Hospital-at-Home 2 programs provide high-touch care to patients at home, while newer HaH programs rely increasingly on high-tech approaches. Although both methods have independently resulted in positive patient experiences, the combined impact of these approaches on patient experiences remains unknown.

Objective:

This study aims to explore the opportunities, limitations, and experiences encountered by patients and their caregivers when receiving both remote and home visits in a HaH program in Singapore.

Methods:

An ethnographic qualitative research design was used. Participants were patients admitted to a HaH program operated in Singapore between November 2022 and May 2023. Data were collected from twenty-one participants via observations during home visits, virtual consultations and in-depth one-to-one interviews.

Results:

Three key themes were identified: i) Positive experiences of remote and home visits, ii) patient-provider dynamics, and iii) complexities of the home as a care setting. While a combination of remote and home visits led to patient satisfaction and addressed administrative and communication issues inherent in purely virtual models, it also suggested hidden costs, role conflicts, and a need for operational optimization. These limitations may be particularly pronounced among individuals of low socio-economic status. Patient proactiveness and its potential to contribute to positive health outcomes emerged as a significant feature to further enhance HaH.

Conclusions:

Our findings support the strategic use of physician home visits as a core component of HaH programs to optimize patient and caregiver experience and the effectiveness of subsequent remote visits. Clinicians and policymakers should use these insights to refine the balance between high-touch and high-tech approaches to delivering HaH care.