Moving Healthcare into the Patient’s Home

Abstract

Hospital at Home is a healthcare concept that has grown in recent years and as the programs develop, organisational and structural questions become increasingly impor- tant. This study explores three Hospital at Home programs across different settings, NUHS@Home in Singapore, HSU Home Hospital in Iceland, and AP-HP HAD in France. The study is based on a literature review and semi-structured case interviews with peo- ple working within these three programs, as well as additional informant interviews with people working in some capacity with HaH-programs. The findings indicate that a suit- able way of organising HaH-programs depends on the context and is shaped by local conditions, history, resources, and organisational structures. The shift of healthcare from hospital to patients’ homes also requires a shift in how care is delivered, as it is not sim- ply a matter of transferring existing processes and routines to the patient’s home, but rather redesigning the way care is provided. This change also increases the importance of collaboration and coordination between different actors within the healthcare system. In addition, organisations must balance differentiation and integration between the program and the hospital to support HaH-specific conditions while ensuring effective integration with the existing healthcare system.