Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study
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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-08-01
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| Series: | Journal of Patient Experience |
| Online Access: | https://doi.org/10.1177/23743735231189354 |
| _version_ | 1797751851239604224 |
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| author | Nels Paulson PhD Margaret P. Paulson DO Michael J. Maniaci MD Rachel A. Rutledge MHA, MAcc Shealeigh Inselman BA. Stephanie J. Zawada MS |
| author_facet | Nels Paulson PhD Margaret P. Paulson DO Michael J. Maniaci MD Rachel A. Rutledge MHA, MAcc Shealeigh Inselman BA. Stephanie J. Zawada MS |
| author_sort | Nels Paulson PhD |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T16:54:38Z |
| format | Article |
| id | doaj.art-624637b2404d4934a740215acc126864 |
| institution | Directory Open Access Journal |
| issn | 2374-3743 |
| language | English |
| last_indexed | 2024-03-12T16:54:38Z |
| publishDate | 2023-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Patient Experience |
| spelling | doaj.art-624637b2404d4934a740215acc1268642023-08-08T09:03:28ZengSAGE PublishingJournal of Patient Experience2374-37432023-08-011010.1177/23743735231189354Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods StudyNels Paulson PhD0Margaret P. Paulson DO1Michael J. Maniaci MD2Rachel A. Rutledge MHA, MAcc3Shealeigh Inselman BA.4Stephanie J. Zawada MS5 , Stout Department of Sociology, Menomonie, WI, USA , Northwest Wisconsin Advanced Care at Home & Home Health, Menomonie, WI, USA , Jacksonville, FL, USA , Jacksonville, FL, USA , Rochester, MN, USA Mayo Clinic College of Medicine and Science, Scottsdale, AZ, USATo 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.https://doi.org/10.1177/23743735231189354 |
| spellingShingle | Nels Paulson PhD Margaret P. Paulson DO Michael J. Maniaci MD Rachel A. Rutledge MHA, MAcc Shealeigh Inselman BA. Stephanie J. Zawada MS Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study Journal of Patient Experience |
| title | Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study |
| title_full | Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study |
| title_fullStr | Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study |
| title_full_unstemmed | Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study |
| title_short | Why U.S. Patients Declined Hospital-at-Home during the COVID-19 Public Health Emergency: An Exploratory Mixed Methods Study |
| title_sort | why u s patients declined hospital at home during the covid 19 public health emergency an exploratory mixed methods study |
| url | https://doi.org/10.1177/23743735231189354 |
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