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The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences
BACKGROUND: Patients with heart failure (HF) experience recurrent hospitalizations and may prefer a Hospital at Home (HaH) model over routine hospitalization. METHODS: We administered a 9-item questionnaire on perceived effectiveness, safety, convenience, and acceptability of a HaH model among patie...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978061/ https://www.ncbi.nlm.nih.gov/pubmed/35386130 http://dx.doi.org/10.1016/j.cjco.2021.10.005 |
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author | Le, NhatChinh Rahman, Tahseen Kapralik, Jessica L. Ibrahim, Quazi Lear, Scott A. Van Spall, Harriette G.C. |
author_facet | Le, NhatChinh Rahman, Tahseen Kapralik, Jessica L. Ibrahim, Quazi Lear, Scott A. Van Spall, Harriette G.C. |
author_sort | Le, NhatChinh |
collection | PubMed |
description | BACKGROUND: Patients with heart failure (HF) experience recurrent hospitalizations and may prefer a Hospital at Home (HaH) model over routine hospitalization. METHODS: We administered a 9-item questionnaire on perceived effectiveness, safety, convenience, and acceptability of a HaH model among patients hospitalized for HF at 2 academic hospitals in Ontario. The primary outcome was HaH care acceptability, defined as a preference for or neutrality to HaH care over routine hospitalization. We used partial Spearman rank correlations (ρ) and multivariable logistic regression analyses to explore associations with outcomes. RESULTS: Of 297 eligible patients, 269 (90.6%) completed the questionnaire. The mean age was 76.2 (standard deviation, 12.3) years; 48.3% were female; and 70.5% lived in their own home, commonly with a relative or caregiver (67.9%). As many as 211 patients (78.4%; 95% confidence interval [CI] 73.0%-83.2%) found HaH care acceptable, with 169 (62.8%; 95% CI, 56.8%-68.6%) preferring HaH care over routine hospitalization. Perceived convenience (ρ, 0.57; P < 0.001) and safety (ρ, 0.37; p < 0.001) were associated with HaH acceptability, whereas perceived effectiveness was not (ρ, 0.14; P = 0.021). A college (adjusted odds ratio [aOR], 5.96; 95% CI, 2.01-17.62; P = 0.001) or university (aOR, 3.58; 95% CI, 1.07-12.06; P = 0.039) education was associated with greater odds of HaH acceptability, whereas residing in a caregiver’s home was associated with lower odds (aOR, 0.34; 95% CI 0.14-0.84; P = 0.019). CONCLUSIONS: A majority of patients with HF perceived HaH care to be an acceptable alternative to routine hospitalization, prioritizing perceived convenience and safety over effectiveness. Postsecondary education and living independently without caregiver support were associated with HaH acceptability. |
format | Online Article Text |
id | pubmed-8978061 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-89780612022-04-05 The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences Le, NhatChinh Rahman, Tahseen Kapralik, Jessica L. Ibrahim, Quazi Lear, Scott A. Van Spall, Harriette G.C. CJC Open Original Article BACKGROUND: Patients with heart failure (HF) experience recurrent hospitalizations and may prefer a Hospital at Home (HaH) model over routine hospitalization. METHODS: We administered a 9-item questionnaire on perceived effectiveness, safety, convenience, and acceptability of a HaH model among patients hospitalized for HF at 2 academic hospitals in Ontario. The primary outcome was HaH care acceptability, defined as a preference for or neutrality to HaH care over routine hospitalization. We used partial Spearman rank correlations (ρ) and multivariable logistic regression analyses to explore associations with outcomes. RESULTS: Of 297 eligible patients, 269 (90.6%) completed the questionnaire. The mean age was 76.2 (standard deviation, 12.3) years; 48.3% were female; and 70.5% lived in their own home, commonly with a relative or caregiver (67.9%). As many as 211 patients (78.4%; 95% confidence interval [CI] 73.0%-83.2%) found HaH care acceptable, with 169 (62.8%; 95% CI, 56.8%-68.6%) preferring HaH care over routine hospitalization. Perceived convenience (ρ, 0.57; P < 0.001) and safety (ρ, 0.37; p < 0.001) were associated with HaH acceptability, whereas perceived effectiveness was not (ρ, 0.14; P = 0.021). A college (adjusted odds ratio [aOR], 5.96; 95% CI, 2.01-17.62; P = 0.001) or university (aOR, 3.58; 95% CI, 1.07-12.06; P = 0.039) education was associated with greater odds of HaH acceptability, whereas residing in a caregiver’s home was associated with lower odds (aOR, 0.34; 95% CI 0.14-0.84; P = 0.019). CONCLUSIONS: A majority of patients with HF perceived HaH care to be an acceptable alternative to routine hospitalization, prioritizing perceived convenience and safety over effectiveness. Postsecondary education and living independently without caregiver support were associated with HaH acceptability. Elsevier 2021-10-20 /pmc/articles/PMC8978061/ /pubmed/35386130 http://dx.doi.org/10.1016/j.cjco.2021.10.005 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Le, NhatChinh Rahman, Tahseen Kapralik, Jessica L. Ibrahim, Quazi Lear, Scott A. Van Spall, Harriette G.C. The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences |
title | The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences |
title_full | The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences |
title_fullStr | The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences |
title_full_unstemmed | The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences |
title_short | The Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences |
title_sort | hospital at home model vs routine hospitalization for acute heart failure: a survey of patients’ preferences |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978061/ https://www.ncbi.nlm.nih.gov/pubmed/35386130 http://dx.doi.org/10.1016/j.cjco.2021.10.005 |
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