• Stephanie Qianwen Ko, Crystal Min Siu Chua, Shu Hua Koh, Yee Wei Lim, and Shefaly Shorey.
• Division of Advanced Internal Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore.
• J Gen Intern Med. 2023 Feb 1; 38 (3): 691698691-698.

BackgroundHospital at Home (HaH) programs have been shown to improve clinical outcomes, quality of care, and patient satisfaction. However, how Asian patients experience HaH remained underexplored.ObjectiveTo explore the perceptions and experiences of patients and caregivers admitted to a hospital-at-home program in Singapore.DesignDescriptive qualitative study design.ParticipantsPurposive sampling was used to conduct 36 interviews with 13 patients, nine Legally Acceptable Representatives (LARs), and 14 caregivers until data saturation was achieved.InterventionsNUHS@Home is a HaH program providing care through a multi-disciplinary team, enabled by remote vital signs monitoring through a tablet and wireless blood pressure and oxygen meters.ApproachThis study used in-depth semi-structured individual interviews. Interviews were transcribed and thematically analyzed using Braun and Clark's six-step inductive approach.Key ResultsThe overarching theme identified was "Enablers, difficulties, and improvements to the HaH experiences" which was supported by three key themes: (1) Perceived better care at home, (2) Importance of social support, and (3) Organizational structures required to support HaH. Participants described overall HaH experiences around factors contributing to their impeding engagement, overall satisfaction, and quality of care.ConclusionsAlthough HaH is unfamiliar to the Singapore population, most of the participants in this study had an overall positive experience. The key challenges found in this paper were the stress and inconvenience caused to caregivers. The enablers for positive HaH experiences were (1) consideration of patient's family members as key participants in the patients' therapeutic alliance; (2) the HaH care team must be accessible, approachable, and reassuring, and communicate frequently and timely with patients and their families; and (3) financing strategies to ensure HaH out-of-pockets costs remain affordable which are critical to keeping HaH as an option for patients and families.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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