Hybrid Hospital-at-Home Program in Singapore: Ethnographic Study

Area of Science:

• Healthcare Delivery Science
• Digital Health
• Qualitative Health Research

Background:

• Hospital-at-Home (HaH) models traditionally rely on in-person care but have evolved to include digital technologies.
• Hybrid HaH models combining remote and in-person care are emerging, yet patient/caregiver experiences remain understudied, especially in diverse Asian healthcare contexts.

Purpose of the Study:

• To explore patient and caregiver experiences with hybrid Hospital-at-Home (HaH) acute care in Singapore.
• Investigate the integration of remote consultations and in-person visits within a hybrid HaH program.

Main Methods:

• Ethnographic qualitative research design.
• Data collected via participant observation and semistructured interviews (November 2022 - May 2023).
• Thematic analysis using an inductive approach.

Main Results:

• Patients reported comfort, convenience, safety, and empowerment with hybrid HaH care.
• In-person visits were vital for rapport, though technology usability and communication posed challenges.
• Home environment limitations, financial burdens, scheduling needs, safety concerns, and caregiver role confusion were identified.

Conclusions:

• Hybrid HaH models require a balance of remote and in-person care, with physician home visits being critical.
• Tailored support, including more frequent in-person visits, is needed for vulnerable patient groups.
• Public education, equitable financing, and consideration of digital literacy and cultural norms are essential for effective hybrid HaH program design.