ACCEPTABILITY TO PATIENTS OF A HOME HOSPITAL

OBJECTIVE: To examine the acceptability to older patients of receiving care in the home for acute medical conditions that require hospital l evel care by current standards. DESIGN: Interviews with patients durin g hospitalization regarding their views of a hypothetical ''home hospi tal.'' PARTICIPANTS: Patients (n = 87) admitted to a community-based a cademic medical center with a primary diagnosis of pneumonia, congesti ve heart failure, or chronic obstructive airway disease, their nurses (n = 111), and resident physicians (67). MEASUREMENTS: A questionnaire was developed to measure several domains of acceptability and expecta tions for care. RESULTS: A majority of patients agreed that treatment in a home hospital would be more comfortable compared with treatment i n a hospital (78.5%), would be less likely to result in an infection ( 62.5%), and would not be a burden to their family (71.8%). There was l ess certainty that medical care at home can be as good as in the hospi tal (56.9%). Nearly three-quarters (72.3%) of patients would choose ho me hospital if it were available. CONCLUSION: Patients may be ready to accept home hospital as an alternative for acute care. The acceptabil ity of home hospital to acutely ill older patients is a critical facto r in the development of this alternative for care and has the potentia l for improving satisfaction with care, reducing complications, hasten ing return to function, and, possibly, of lowering costs of care.