How Social Connectedness Helps Patients Stay Home After Hospital at Home Enrollment: A Mixed Methods Study.

Area of Science:

• Healthcare delivery models
• Social determinants of health
• Patient support systems

Background:

• Hospital at Home (HaH) programs shift care from inpatient settings to patients' homes.
• Patients in HaH rely on their social networks for support typically provided by hospital staff.
• Understanding the role of social connectedness is crucial for HaH program success.

Purpose of the Study:

• To investigate the association between social connectedness and patient outcomes within a Hospital at Home program.
• To identify factors influencing patient enrollment and recovery in HaH settings.
• To explore the impact of social support structures on healthcare utilization and readmission rates.

Main Methods:

• An explanatory iterative sequential mixed methods design was employed.
• Quantitative data from electronic health records (100 HaH patients) assessed illness severity and healthcare utilization.
• Qualitative data from semi-structured interviews (33 patients) explored patient experiences and social support.

Main Results:

• Patients enrolled in HaH due to factors like perceived hospital staff inattention, loneliness, and family encouragement.
• Robust social support within the home environment facilitated patient recovery during HaH.
• Limited social support at home was associated with a higher likelihood of hospital readmission.

Conclusions:

• Structural social connectedness is a key facilitator of patient recovery in Hospital at Home programs.
• Clinicians should conduct comprehensive social histories before HaH enrollment, assessing social roles, responsibilities, and technology acceptance.
• Early engagement of formal and informal caregivers is essential for successful HaH patient support and recovery.