Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 2002 Jan; 52(474): 9–13.
PMCID: PMC1314211

Patient and carer satisfaction with 'hospital at home': quantitative and qualitative results from a randomised controlled trial.


BACKGROUND: 'Hospital At Home' schemes are set to increase in the United Kingdom (UK) in response to the NHS Plan. To date, little detailed work has been done on the acceptability of these schemes to patients and their carers. AIM: To compare Hospital at Home patient and carer satisfaction with hospital care. DESIGN OF STUDY: Pragmatic randomised controlled trial. SETTING: Consecutive patients assessed as suitablefor the Leicester Hospital at Home scheme were randomised to Hospital at Home or one of three acute hospitals in the city. METHOD: Patient satisfaction was assessed two weeks after randomisation, or at discharge if later using a six-item questionnaire. Patients' and carers' views of the services were assessed by semistructured interviews. RESULTS: One hundred and two patients were randomised to Hospital at Home and 97 to hospital. Forty-eight (47%) patients in the Hospital at Home arm and 35 (36%) in the hospital arm completed the satisfaction questionnaire, representing 96% and 85% of those eligible, respectively. Total scores were significantly higher in the Hospital at Home (median = 15) than in the hospital group (median = 12). (P<0.001, Mann-Whitney U-test.) Responses to all six questions favoured Hospital at Home, with all but one of these differences being statistically significant. In the Hospital at Homegroup, 24 patients and 18 of their carers were interviewed; in the hospital group 18 patients and seven of their carers were interviewed. Themes emerging from these interviews were that patients appreciated the more personal care and better communication offered by Hospital at Home and placed great value on staying at home, which was seen to be therapeutic. Patients largely felt safe in Hospital at Home, although some would have felt safer in hospital. Some patients and carers felt that better medical care would have been provided in hospital. Carers felt that the workload imposed by Hospital at Home was no greater than by hospital admission and that the relief from care duties at home would be counterbalanced by the added strain of hospital visiting. CONCLUSIONS: Patient satisfaction was greater with Hospital at Home than with hospital. Reasons included a more personal style of care and a feeling that staying at home was therapeutic. Carers did not feel that Hospital at Home imposed an extra workload.

Full Text

The Full Text of this article is available as a PDF (74K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hensher M, Fulop N, Coast J, Jefferys E. The hospital of the future. Better out than in? Alternatives to acute hospital care. BMJ. 1999 Oct 23;319(7217):1127–1130. [PMC free article] [PubMed]
  • Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000 Sep 16;321(7262):694–696. [PMC free article] [PubMed]
  • Montalto M. Patients' and carers' satisfaction with hospital-in-the-home care. Int J Qual Health Care. 1996 Jun;8(3):243–251. [PubMed]
  • Caplan GA, Ward JA, Brennan NJ, Coconis J, Board N, Brown A. Hospital in the home: a randomised controlled trial. Med J Aust. 1999 Feb 15;170(4):156–160. [PubMed]
  • Davies L, Wilkinson M, Bonner S, Calverley PM, Angus RM. "Hospital at home" versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial. BMJ. 2000 Nov 18;321(7271):1265–1268. [PMC free article] [PubMed]
  • Richards SH, Coast J, Gunnell DJ, Peters TJ, Pounsford J, Darlow MA. Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care. BMJ. 1998 Jun 13;316(7147):1796–1801. [PMC free article] [PubMed]
  • Gunnell D, Coast J, Richards SH, Peters TJ, Pounsford JC, Darlow MA. How great a burden does early discharge to hospital-at-home impose on carers? A randomized controlled trial. Age Ageing. 2000 Mar;29(2):137–142. [PubMed]
  • Shepperd S, Harwood D, Jenkinson C, Gray A, Vessey M, Morgan P. Randomised controlled trial comparing hospital at home care with inpatient hospital care. I: three month follow up of health outcomes. BMJ. 1998 Jun 13;316(7147):1786–1791. [PMC free article] [PubMed]
  • Wilson A, Parker H, Wynn A, Jagger C, Spiers N, Jones J, Parker G. Randomised controlled trial of effectiveness of Leicester hospital at home scheme compared with hospital care. BMJ. 1999 Dec 11;319(7224):1542–1546. [PMC free article] [PubMed]
  • Pound P, Gompertz P, Ebrahim S. Development and results of a questionnaire to measure carer satisfaction after stroke. J Epidemiol Community Health. 1993 Dec;47(6):500–505. [PMC free article] [PubMed]
  • Montalto M. Hospital in the home: take the evidence and run. Med J Aust. 1999 Feb 15;170(4):148–149. [PubMed]
  • Bruster S, Jarman B, Bosanquet N, Weston D, Erens R, Delbanco TL. National survey of hospital patients. BMJ. 1994 Dec 10;309(6968):1542–1546. [PMC free article] [PubMed]
  • Forgan Morle KM. Patient satisfaction: care of the elderly. J Adv Nurs. 1984 Jan;9(1):71–76. [PubMed]
  • Fitzpatrick R. Surveys of patients satisfaction: I--Important general considerations. BMJ. 1991 Apr 13;302(6781):887–889. [PMC free article] [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...