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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...

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Autores principales: Le, NhatChinh, Rahman, Tahseen, Kapralik, Jessica L., Ibrahim, Quazi, Lear, Scott A., Van Spall, Harriette G.C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
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.
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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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