“The right people at the right time”: process evaluation of a novel allied health hospital in the home service for people with cancer

TL;DR

This study evaluated a new home-based allied health service for cancer patients, finding it timely, safe, and cost-effective compared to inpatient care.

Contribution

The study introduces and evaluates a novel allied health hospital-in-the-home model for cancer care.

Findings

69 out of 90 cancer patients participated in the program with no major adverse events.

The service had a median wait time of 5 days and cost $518 AUD per patient contact.

Staff reported the service added value by preventing hospital readmissions and improving outcomes.

Abstract

To perform a process evaluation of the acceptability, adoption, costs, feasibility, safety, timeliness, and satisfaction of a novel allied health program in Hospital in the Home (HITH) cancer services.

A mixed-methods process evaluation using the proctor model for implementation was completed. Quantitative data from routinely collected service data, patient satisfaction surveys, and qualitative focus group data from cancer services’ staff over a 6-month period were analysed. Quantitative data were described, and qualitative data thematically analysed and mapped to seven key domains: acceptability, adoption, costs, feasibility, safety, timeliness, and satisfaction.

A total of 90 adults with cancer were referred to the allied health program in HITH cancer services, of which 69 (77%) participated. There were no major adverse events, and entry to the service was timely (median wait time: 5 days). Patients were satisfied with the service. Clinical staff reported the service “added value” by preventing hospital readmission and improving patient outcomes. The cost of the service was $518 AUD per patient contact (comparable inpatient stay: $5000 AUD).

A timely home-based allied health cancer service can be achieved with adequate resources, communication, and collaboration. Future home-based models of allied health care for people with cancer should consider employing skilled staff and strategically aligning programs with health service priorities.

The online version contains supplementary material available at 10.1007/s00520-025-09694-1.

Figures