# Perceptions and anticipated factors influencing the adoption of early supported discharge through hospital-at-home

## TL;DR

This study explores how patients in Singapore perceive and anticipate factors affecting their acceptance of hospital-at-home care through early supported discharge.

## Contribution

This is the first qualitative study on patient perceptions of early supported discharge in an Asian context.

## Key findings

- Patients generally perceive benefits like home comfort and societal advantages from hospital-at-home care.
- Challenges include unsuitable home environments, lack of social support, and technological concerns.
- Perceived care adequacy and financial considerations significantly influence willingness to adopt early supported discharge.

## Abstract

Hospital-at-home (HaH) is an alternative care model that allows patients to receive quality, individualized care from their homes. This can reduce hospital bed utilization through early supported discharge (ESD) or admission avoidance (AA).

This study aimed to explore the patient’s perceptions and anticipated factors of this model of care with a focus on the factors that affect their acceptance of ESD in a multi-ethnic Asian country that remains underexplored.

A qualitative study was conducted on eligible inpatients with HaH in an acute tertiary hospital in Singapore. Semi-structured interviews were used to explore patients’ views and expectations when deciding to enroll in the HaH. The data were transcribed and analyzed using Braun and Clarke’s thematic analysis framework.

Interview responses were obtained from 24 patients. The key themes identified were: (1) perceived benefits, (2) perceived adequacy of care, (3) potential challenges and barriers, and (4) financial considerations. Perception toward ESD was generally positive with patients citing benefits such as home comfort as well as societal benefits offered by HaH. Potential challenges for patients are diverse, including unsuitable home environments, lack of social support, and technological concerns. The patients’ perceived adequacy of care received from HaH and financial considerations also varied among patients and either positively or negatively affected the willingness for ESD-HaH. The relevance and implications of these factors were further explored, and insights were provided into measures to facilitate the successful implementation of HaH services in Singapore.

This is the first qualitative study conducted on in patients undergoing ESD to explore their anticipated factors influencing the adoption of a relatively new model of care in the Asian community. Addressing the identified themes could improve the adoption of ESD both nationwide and regionally.