# Hospital-at-Home for South Asian Communities in British Columbia, Canada: Qualitative Interview Study

## TL;DR

This study explores how South Asian communities in British Columbia perceive Hospital-at-Home services and identifies ways to make these services more accessible and culturally appropriate.

## Contribution

The study provides insights into cultural barriers and facilitators for Hospital-at-Home services among South Asian communities in Canada.

## Key findings

- Participants highlighted systemic barriers like long wait times and lack of culturally appropriate care in traditional hospitals.
- Virtual Hospital-at-Home services were valued for convenience but raised concerns about clinical quality and digital literacy.
- Culturally tailored outreach through community leaders and media is emphasized to improve trust and awareness.

## Abstract

South Asian communities in Canada face significant disparities in access to health care and experience higher rates of chronic conditions such as cardiovascular disease, diabetes, and hypertension. Hospital-at-Home services have the potential to improve access and outcomes, yet little is known about how these services are perceived and experienced by South Asian patients and caregivers. Understanding both barriers and facilitators is critical for culturally responsive implementation.

This study aimed to explore the experiences of South Asian community members with in-person hospital care and their perceptions, attitudes, and expectations regarding virtual Hospital-at-Home services, with the goal of identifying culturally tailored strategies to improve access, quality, and satisfaction.

A qualitative study using semistructured interviews was conducted with 20 South Asian community members in the Fraser Health region in British Columbia, Canada. Interviews explored experiences with in-person hospital care, perceptions of a virtual hospital service (also known as Hospital-at-Home), and recommendations for enhancing awareness and accessibility. Interviews were audio-recorded, transcribed, and analyzed thematically to identify key patterns in perceptions, experiences, and needs.

Participants described multiple systemic barriers to in-person hospital care, including long wait times, overcrowding, transportation challenges, and difficulty navigating the health system. Cultural and religious needs, such as gender-concordant care and culturally appropriate food, were frequently unmet, while language-concordant care and family involvement were critical to positive experiences. Discrimination and assumptions based on ethnicity or age further shaped perceptions of care. Virtual hospital services were valued for convenience, comfort, reduced exposure to hospital-acquired infections, and support for family involvement. However, participants raised concerns about clinical quality, the absence of physical examinations, digital literacy, privacy, and home-based responsibilities. Acceptance varied by age, immigration status, and familiarity with technology. Participants emphasized the importance of culturally tailored outreach, leveraging community leaders, ethnic media, and peer testimonials to increase awareness and trust.

South Asian patients and caregivers recognize both challenges in traditional hospital care and potential benefits of Hospital-at-Home services. Implementation strategies that address systemic barriers, integrate cultural and linguistic considerations, and engage trusted community networks are essential to improving equity, access, and satisfaction. Findings highlight the need for culturally responsive, patient-centered approaches in the design and delivery of virtual health services for racialized populations.