Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada

<p>Abstract</p> <p>Background</p> <p>Hospital in the home programs have been implemented in several countries and have been shown to be safe substitutions (alternatives) to in-patient hospitalization. These programs may offer a solution to the increasing demands made on...

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Main Authors: Zhang Wei, Martin Carmel M, Armstrong Catherine, Dahrouge Simone, Hogg William E, Lemelin Jacques, Dusseault Jo-Anne, Parsons-Nicota Joy, Saginur Raphael, Viner Gary
Format: Article
Language:English
Published: BMC 2007-08-01
Series:BMC Health Services Research
Online Access:http://www.biomedcentral.com/1472-6963/7/130
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author Zhang Wei
Martin Carmel M
Armstrong Catherine
Dahrouge Simone
Hogg William E
Lemelin Jacques
Dusseault Jo-Anne
Parsons-Nicota Joy
Saginur Raphael
Viner Gary
author_facet Zhang Wei
Martin Carmel M
Armstrong Catherine
Dahrouge Simone
Hogg William E
Lemelin Jacques
Dusseault Jo-Anne
Parsons-Nicota Joy
Saginur Raphael
Viner Gary
author_sort Zhang Wei
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Hospital in the home programs have been implemented in several countries and have been shown to be safe substitutions (alternatives) to in-patient hospitalization. These programs may offer a solution to the increasing demands made on tertiary care facilities and to surge capacity. We investigated the acceptance of this type of care provision with nurse practitioners as the designated principal home care providers in a family medicine program in a large Canadian urban setting.</p> <p>Methods</p> <p>Patients requiring hospitalization to the family medicine service ward, for any diagnosis, who met selection criteria, were invited to enter the hospital in the home program as an alternative to admission. Participants in the hospital in the home program, their caregivers, and the physicians responsible for their care were surveyed about their perceptions of the program. Nurse practitioners, who provided care, were surveyed and interviewed.</p> <p>Results</p> <p>Ten percent (104) of admissions to the ward were screened, and 37 patients participated in 44 home hospital admissions. Twenty nine patient, 17 caregiver and 38 provider surveys were completed. Most patients (88%–100%) and caregivers (92%–100%) reported high satisfaction levels with various aspects of health service delivery. However, a significant proportion in both groups stated that they would select to be treated in-hospital should the need arise again. This was usually due to fears about the safety of the program. Physicians (98%–100%) and nurse practitioners also rated the program highly. The program had virtually no negative impact on the physician workload. However nurse practitioners felt that the program did not utilize their full expertise.</p> <p>Conclusion</p> <p>Provision of hospital level care in the home is well received by patients, their caregivers and health care providers. As a new program, investment in patient education about program safety may be necessary to ensure its long term success. A small proportion of hospital admissions were screened for this program. Appropriate dissemination of program information to family physicians should help buy-in and participation. Nurse practitioners' skills may not be optimally utilized in this setting.</p>
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spelling doaj.art-927ae74f16764562899ba749da390c7d2022-12-22T02:48:36ZengBMCBMC Health Services Research1472-69632007-08-017113010.1186/1472-6963-7-130Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, CanadaZhang WeiMartin Carmel MArmstrong CatherineDahrouge SimoneHogg William ELemelin JacquesDusseault Jo-AnneParsons-Nicota JoySaginur RaphaelViner Gary<p>Abstract</p> <p>Background</p> <p>Hospital in the home programs have been implemented in several countries and have been shown to be safe substitutions (alternatives) to in-patient hospitalization. These programs may offer a solution to the increasing demands made on tertiary care facilities and to surge capacity. We investigated the acceptance of this type of care provision with nurse practitioners as the designated principal home care providers in a family medicine program in a large Canadian urban setting.</p> <p>Methods</p> <p>Patients requiring hospitalization to the family medicine service ward, for any diagnosis, who met selection criteria, were invited to enter the hospital in the home program as an alternative to admission. Participants in the hospital in the home program, their caregivers, and the physicians responsible for their care were surveyed about their perceptions of the program. Nurse practitioners, who provided care, were surveyed and interviewed.</p> <p>Results</p> <p>Ten percent (104) of admissions to the ward were screened, and 37 patients participated in 44 home hospital admissions. Twenty nine patient, 17 caregiver and 38 provider surveys were completed. Most patients (88%–100%) and caregivers (92%–100%) reported high satisfaction levels with various aspects of health service delivery. However, a significant proportion in both groups stated that they would select to be treated in-hospital should the need arise again. This was usually due to fears about the safety of the program. Physicians (98%–100%) and nurse practitioners also rated the program highly. The program had virtually no negative impact on the physician workload. However nurse practitioners felt that the program did not utilize their full expertise.</p> <p>Conclusion</p> <p>Provision of hospital level care in the home is well received by patients, their caregivers and health care providers. As a new program, investment in patient education about program safety may be necessary to ensure its long term success. A small proportion of hospital admissions were screened for this program. Appropriate dissemination of program information to family physicians should help buy-in and participation. Nurse practitioners' skills may not be optimally utilized in this setting.</p>http://www.biomedcentral.com/1472-6963/7/130
spellingShingle Zhang Wei
Martin Carmel M
Armstrong Catherine
Dahrouge Simone
Hogg William E
Lemelin Jacques
Dusseault Jo-Anne
Parsons-Nicota Joy
Saginur Raphael
Viner Gary
Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada
BMC Health Services Research
title Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada
title_full Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada
title_fullStr Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada
title_full_unstemmed Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada
title_short Patient, informal caregiver and care provider acceptance of a hospital in the home program in Ontario, Canada
title_sort patient informal caregiver and care provider acceptance of a hospital in the home program in ontario canada
url http://www.biomedcentral.com/1472-6963/7/130
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