Chua Crystal Min Siu, Ko Stephanie Qianwen, Lai Yi Feng, Lim Yee Wei, Shorey Shefaly
From the Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
Division of Advanced Internal Medicine, Department of Medicine, National University Hospital.
J Patient Saf. 2022 Apr 1;18(3):e606-e612. doi: 10.1097/PTS.0000000000000890.
Hospital at Home (HaH) programs have been shown to improve quality of care and patient satisfaction, and reduce bed occupancy rate in hospitals. Despite the prevalence of HaH in Western countries, studies in Asia are limited and the perception of HaH remains underexplored in Asian context. Understanding the perceptions of stakeholders is vital before implementing HaH in any new settings. Thus, the aim of this study is to explore the perceptions of referring physicians, care providers, patients, and caregivers on HaH programs in a multiracial country such as in Singapore.
This study used a descriptive qualitative design. Participants from 2 tertiary hospitals in Singapore, including 13 referring physicians, 10 care providers, 15 patients, and 3 caregivers, were interviewed between June 2020 and September 2020. Data were analyzed using inductive thematic analysis.
The overarching theme titled "The stakeholders' perception on HaH" was pillared by 4 main themes: (1) patients suitable for HaH; (2) perceived advantages and benefits of HaH; (3) perceived risks, anxiety, and concerns about HaH; and (4) potential enablers of HaH. Overall, the findings reported that most of the stakeholders embraced HaH. Timely medical interventions and support from care providers were reportedly important factors to maintain patient safety and quality of care. The importance of having adequate resources and sound financing mechanisms to develop a successful HaH program was also highlighted.
This study offered insights into HaH from the perspectives of stakeholders in Singapore and facilitate the planning of future HaH pilot programs in multiracial Singapore and other Asian countries.
居家医院（HaH）项目已被证明可提高医疗质量和患者满意度，并降低医院床位占用率。尽管HaH在西方国家很普遍，但亚洲的相关研究有限，在亚洲背景下对HaH的认知仍未得到充分探索。在任何新环境中实施HaH之前，了解利益相关者的看法至关重要。因此，本研究的目的是探讨转诊医生、护理人员、患者和照顾者对新加坡这样一个多民族国家的HaH项目的看法。
本研究采用描述性定性设计。2020年6月至2020年9月期间，对新加坡2家三级医院的参与者进行了访谈，包括13名转诊医生、10名护理人员、15名患者和3名照顾者。采用归纳主题分析法对数据进行分析。
名为“利益相关者对HaH的看法”的总体主题由4个主要主题支撑：（1）适合HaH的患者；（2）HaH的感知优势和益处；（3）对HaH的感知风险、焦虑和担忧；（4）HaH的潜在推动因素。总体而言，研究结果表明，大多数利益相关者接受HaH。据报道，及时的医疗干预和护理人员的支持是维持患者安全和医疗质量的重要因素。还强调了拥有充足资源和健全融资机制对成功开展HaH项目的重要性。
本研究从新加坡利益相关者的角度提供了对HaH的见解，并有助于在多民族的新加坡和其他亚洲国家规划未来的HaH试点项目。
