TY - JOUR
T1 - Satisfaction with hospital at home care
AU - Leff, Bruce
AU - Burton, Lynda
AU - Mader, Scott
AU - Naughton, Bruce
AU - Burl, Jeffrey
AU - Clark, Rebecca
AU - Greenough, William B.
AU - Guido, Susan
AU - Steinwachs, Donald
AU - Burton, John R.
PY - 2006/9
Y1 - 2006/9
N2 - OBJECTIVES: 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. DESIGN: Survey questionnaire of participants in prospective, nonrandomized clinical trial. SETTING: Three Medicare-managed care health systems and a Department of Veterans Affairs Medical Center. PARTICIPANTS: 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. INTERVENTION: Treatment in a Hospital at Home model of care that substitutes for treatment in an acute care hospital. MEASUREMENTS: 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. CONCLUSION: 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.
AB - OBJECTIVES: 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. DESIGN: Survey questionnaire of participants in prospective, nonrandomized clinical trial. SETTING: Three Medicare-managed care health systems and a Department of Veterans Affairs Medical Center. PARTICIPANTS: 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. INTERVENTION: Treatment in a Hospital at Home model of care that substitutes for treatment in an acute care hospital. MEASUREMENTS: 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. CONCLUSION: 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.
KW - Aged
KW - Chronic care
KW - Hospital at home
KW - Quality of care
KW - Satisfaction with care
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U2 - 10.1111/j.1532-5415.2006.00855.x
DO - 10.1111/j.1532-5415.2006.00855.x
M3 - Article
C2 - 16970642
AN - SCOPUS:33748428165
SN - 0002-8614
VL - 54
SP - 1355
EP - 1363
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 9
ER -