Patient Satisfaction and Public Perception of Hospital at Home

As the possibility of a five-year extension of the Acute Hospital Care at Home waiver is under consideration, those of us in the hospital-at-home industry are looking to the future growth of these programs and the strategies necessary to ensure high-quality outcomes and scalability. Alongside this, we must be aware of our most important stakeholders: our patients. How do they feel about this approach to care, and what is the public’s current understanding of it??

Still a relatively new idea?

Hospital at home was largely out of the public eye in the United States pre-COVID, with few programs in operation. The public health emergency propelled it forward and now the model of care is available at over 300 hospitals nationwide. However, much of the public still hasn’t encountered the concept. New studies are beginning to explore public perception of hospital at home, including one recently published in the Journal of the American Medical Association.?

That survey found that 83% of respondents had either a neutral or favorable response to the concept of receiving hospital care at home. These numbers follow what we’ve observed at Contessa, with a roughly 80% patient acceptance rate (for eligible patients offered admission to Recovery Care at Home, our hospital-at-home program).?

Patient satisfaction outcomes at Contessa?

In the JAMA survey, 47% of respondents felt hospital-at-home care was an acceptable alternative to inpatient care. These numbers reflect the perception of members of the general public that may not have necessarily experienced hospital at home, and hints at an overall lack of familiarity with the concept.?

For those who do receive hospital-level care at home, the patient satisfaction ratings are consistently high. Our Top-Box scores (a rating of 9 or 10 out of 10) for patients receiving care via the waiver are high, as reflected in these questions:??

• On a scale from 0 to 10, where 0 is the worst treatment and care possible and 10 is the best treatment and care possible, what number would you rate your treatment and care with Hospitalization at Home?? 88%?

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• On a scale from 0 to 10, where 0 means you would not recommend and 10 means you would fully recommend, would you recommend Hospitalization at Home to your friends and family?? 91%?

?As programs continue to scale and expand, it’s reasonable to conclude that growth will translate to more people who have either direct experience with hospital at home or have heard about it from someone they know. Consistently high patient satisfaction ratings suggest that greater exposure will bolster public perception of the model of care.?

A two-prong approach to increasing awareness?

Although 300-plus hospitals are a sizable number, there are approximately 6,120 total hospitals in the United States. Given that, only 5% of hospitals currently have a hospital-at-home program, which equals a large number of patients and physicians that have not encountered the model of care.?

In conversations with our hospital-at-home patients, we often find that those who were hesitant initially to try out a new model of care overcome that hesitation when their personal physician or attending hospitalist recommend it as a safe and effective alternative to hospital inpatient care.?

Advocacy and education, then, means ensuring that we continue to broadcast the benefits of hospital-level care at home to a wide audience of both patients and physicians. Studies continue to show excellent care outcomes with hospital-at-home care, and increasing awareness of this for physician referrals is a key driver for the growth of these programs. This will become even more crucial as the percentage of hospitals who adopt them increases.?

To do so, leveraging strategies such as emergency department posters, educational “lunch and learns” for staff unfamiliar with hospital at home, and regular communication of virtual bed capacity will prove valuable. At Contessa, our Recovery Care Coordinators (RCCs), who support patient eligibility assessments and admissions, also serve as liaisons with the larger medical community in the health systems they serve, helping to familiarize physicians with the programs.?

Long-term confidence for patients?

With 91% of our patients saying they would recommend the model to family and friends, and strong physician support in the field, we have confidence that hospital at home will build long-term confidence in the public sector as it continues to evolve in upcoming years. In an era where more than 70% of Americans are unhappy with healthcare delivery, hospital at home will remain an invaluable solution in healthcare’s toolbox for improving patient care and satisfaction.?

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