Portions of this work were presented at the annual meetings of the American Geriatrics Society, May 2002, and the Gerontological Society of America, November 2002.
Comparison of Stress Experienced by Family Members of Patients Treated in Hospital at Home with That of Those Receiving Traditional Acute Hospital Care
Version of Record online: 4 NOV 2007
Journal of the American Geriatrics Society
Volume 56, Issue 1, pages 117–123, January 2008
How to Cite
Leff, B., Burton, L., Mader, S. L., Naughton, B., Burl, J., Koehn, D., Clark, R., Greenough, W. B., Guido, S., Steinwachs, D. and Burton, J. R. (2008), Comparison of Stress Experienced by Family Members of Patients Treated in Hospital at Home with That of Those Receiving Traditional Acute Hospital Care. Journal of the American Geriatrics Society, 56: 117–123. doi: 10.1111/j.1532-5415.2007.01459.x
- Issue online: 4 NOV 2007
- Version of Record online: 4 NOV 2007
- “Hospital at Home”;
- hospital care;
- acute care for the elderly
OBJECTIVES: To compare differences in the stress experienced by family members of patients cared for in a physician-led substitutive Hospital at Home (HaH) and those receiving traditional acute hospital care.
DESIGN: Survey questionnaire completed as a component of a prospective, nonrandomized clinical trial of a substitutive HaH care model.
SETTING: Three Medicare managed care health systems and a Veterans Affairs Medical Center.
PARTICIPANTS: Two hundred fourteen community-dwelling elderly patients who required acute hospital admission for community-acquired pneumonia, exacerbation of chronic heart failure, exacerbation of chronic obstructive pulmonary disease, or cellulitis.
INTERVENTION: Treatment in a substitutive HaH model.
MEASUREMENTS: Fifteen-question survey questionnaire asking family members whether they experienced a potentially stressful situation and, if so, whether stress was associated with the situation while the patient received care.
RESULTS: The mean and median number of experiences, of a possible 15, that caused stress for family members of HaH patients was significantly lower than for family members of acute care hospital patients (mean ± standard deviation 1.7 ± 1.8 vs 4.3 ± 3.1, P<.001; median 1 vs 4, P<.001). HaH care was associated with lower odds of developing mean levels of family member stress (adjusted odds ratio=0.12, 95% confidence interval=0.05–0.30).
CONCLUSION: HaH is associated with lower levels of family member stress than traditional acute hospital care and does not appear to shift the burden of care from hospital staff to family members.