Age UK. Later life in the United Kingdom. 2018. (accessed 22 February 2019)

Brody AA, Arbaje AI, De Cherrie LV, Federman AD, Leff B, Siu AL. Starting up a hospital at home program: facilitators and barriers to implementation. J Am Geriatr Soc. 2019;

Caplan GA, Ward JA, Brennan NJ Hospital in the home: a randomised controlled trial. Med J Aust. 1999; 170:(4)156-160

Hardy G, West M. Happy talk. Health Serv J. 1994; 7:24-26

Reshaping the workforce to deliver the care patients need. 2016. (accessed 22 February 2019)

Imison C, Poteliakhoff E, Thompson J. Older people and emergency bed use.London: The King's Fund; 2012

Jester R, Hicks C. Using cost effectiveness analysis to compare hospital at home and in-patient interventions. J Clin Nurs. 2003; 12:(1)20-27

Jester R, Titchener K, Doyle-Blunden J, Caldwell C. The development of an evaluation framework for a Hospital at Home Service: Lessons from the literature. J Integrated Care. 2015; 23:(6)336-351

Lee G, Pickstone N, Facultad J, Titchener K. The future of community nursing: hospital in the home. Br J Community Nurs. 2017; 22:(4)650-654

Lee G, Sakone P, Mulhall H, Kelleher K, Burnett K. Using hospital-at-home to reduce admissions. Nurs Times. 2015; 111:(36/37)12-15

Lee G, Titchener K. The Guy's and St Thomas's NHS Foundation Trust @ home service: an overview of a new service. London J Prim Care. 2017; 9:(2)18-22

Montalto M. The 500-bed hospital that isn't there: the Victorian Department of Health review of the hospital in the home program. Med J Aust. 2010; 193:(10)598-601

Montalto M, Lui B, Mullins A, Woodmason K. Medically-managed Hospital in the Home: 7 year study of mortality and unplanned interruption. Australian Health Review. 2010; 34:(3)269-75

NHS England. Family and friends test data. 2019a. (accessed 22 February 2019)

NHS England. NHS long term plan. 2019b. (accessed 22 February 2019)

Rodriguez-Cerrillo M, Fernandez-Diaz E, Inurrieta-Romero A, Poza-Montoro A. Implementation of a quality management system according to 9001 standard in a hospital in the home unit: changes and achievements. Int J Health Care Qual Assur. 2012; 25:(6)498-508

Royal College of Surgeons. NHS bed occupancy rates now at worst ever, new figures show. 2018. (accessed 22 February 2019)

Scanlon A, Lee G. The use of the term vulnerability in acute care: why does it differ and what does it mean?. Aust J Adv Nurs. 2007; 24:(3)54-59

What is integrated care?. 2011. (accessed 27 February 2019)

The King's Fund. The King's Fund responds to the latest NHS performance figures. 2019. (accessed 22 February 2019)

Utens C, Goosens L, van Schayck O Evaluation of health care providers' role transition and satisfaction in hospital at home for chronic obstructive pulmonary disease exacerbations: a survey study. BMC Health Serv Res. 2013; 13

Van Donk P, Rickard CM, McGrail MR, Doolan G. Routine replacement versus clinical monitoring of peripheral intravenous catheters in a regional hospital in the home program: a randomized controlled trial. Infect Control Hosp Epidemiol. 2009; 30:(9)915-917

Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013; 15:398-405

Varney J, Welland TJ, Jelinek G. Efficacy of hospital in the home services providing care for patients admitted from emergency department: an integrative review. Int J Evid Based Healthc. 2014; 12:128-141

Patient satisfaction with a hospital-in-the-home service

02 April 2019
Volume 24 · Issue 4


The hospital-in-the-home (HitH) model is an alternative model of healthcare that allows patients to return home and receive short-term treatment in a familiar environment. The objective of the present study was to evaluate patient satisfaction with the GSTT@home service in the London boroughs of Southwark and Lambeth. A questionnaire comprising 20 questions was developed with 5-point Likert response and free text options. A total of 1426 questionnaires were distributed, of which 206 (14%) were returned. The majority of respondents said they would recommend the @home service (n=200, 97%) and were very satisfied or satisfied with the service (n=203, 99%). Only 48 respondents provided qualitative free text comments, and overall, these were very positive and supportive of the @home service. The findings support the benefits of the @home model of care from the patients' perspective.

At present, the NHS is facing unprecedented demands on its services, with 11.8 million people over 65 years and 4 million people with long-term illnesses living in the UK (Age UK, 2018). Alongside this, emergency department (ED) staff are witnessing the highest ever bed occupancy rates, which underlie their aim to discharge patients back into the community for further management (Royal College of Surgeons, 2018). A King's Fund report highlighted the need for better alignment of primary, community and acute care to reduce avoidable hospital admissions and length of hospital stay (Imison et al, 2012), and this has been re-enforced in the recently published NHS Long Term Plan (NHS England, 2019a). The ‘hospital-in-the-home’ (HitH) model is one solution that allows patients to return home and receive short-term treatment in a familiar environment. Since its inception in 2014 (Lee and Titchener, 2017), many countries have created their own version of HitH services and reported very positive results in terms of various aspects, including efficacy, safety, cost and patient satisfaction (Caplan et al, 1999; Van Donk et al, 2009; Montalto, 2010; Rodriguez-Cerrillo et al, 2012; Varney et al, 2014). Studies have also highlighted the need for strategic planning and coordinated partnerships to ensure the success of HitH services (Brody et al, 2019). One study noted that the use of HitH resulted in a reduction in hospital readmissions from 7% to 3% (Rodriguez-Cerrillo et al, 2012). Another review of HitH services concluded that HitH care was at least equivalent to hospital-based care and offered greater cost savings (Varney et al, 2014). In terms of satisfaction with the HitH service, the literature reports the positive impact of HitH on patient care and notes the overall efficacy of the HitH programme (Caplan et al, 1999; Montalto, 2010; Montalto et al, 2010; Varney et al, 2014). Patient satisfaction is a goal in its own right and, more importantly, it is an important determinant of patient concordance with advice and treatment. Patient views are considered a legitimate, important measure of care quality and an indirect measure of health outcome (Hardy and West, 1994).

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