The rise of in-home alternatives to traditional hospital care is raising concerns about the potential strain these models may place on family caregivers. Under the hospital-at-home (HaH) model, it is essential to ensure that caregivers are not inadvertently overwhelmed with additional tasks and responsibilities that exceed their capacity and resources.

DispatchHealth recently conducted a study analyzing the impact of the HaH model on caregivers’ lives and well-being. The organization aimed to understand whether the shift from traditional in-patient hospitalization to home-based treatment introduces more or fewer challenges specific to caregivers.

Denver-based DispatchHealth provides high-acuity, in-home medical care for those experiencing serious health concerns.

The caregivers surveyed provided care to patients with an average age of 78 and an average of 11 comorbidities, including those with non-respiratory infections, heart failure and pneumonia.

Roughly 95% of respondents strongly preferred in-home care over the traditional hospital setting, with 68% stating a solid preference for hospital-level care in the home.

“It’s no surprise, given that our net promoter score consistently exceeds 90,” Dr. Patrick Kneeland, vice president of medical affairs at DispatchHealth, told Home Health Care News. “People want to heal at home. Being in the hospital is not often convenient for the patient or their caregivers. We have direct experience with an observation of social determinants of health that are impacting a patient’s overall health and success at home. You also avoid the risk of hospital-acquired infections, and patients tend to stay more mobile and connected to their routines, which can help speed recovery.” 

Regarding stress levels, 96% of surveyed caregivers found in-home care less stressful than a previous in-patient hospital experience.

“We recently measured caregiver experience in the hospital-alternative care model and found an overwhelming preference of caregivers for our model over the hospital,” Kneeland explained. “While it can be a balancing act, caregivers reported that our model was typically less stressful than navigating a traditional hospital stay. That said, not all patients are clinically ideal for hospital-alternative care – some patients and families are already overwhelmed at home and we keep that in mind.”

Approximately 25% of patients integrated into the HaH program took advantage of the Centers for Medicare & Medicaid Services (CMS) waiver program, while the rest were covered by insurance other than traditional Medicare.

Most of the caregiver participants were either a spouse or an adult child. A significant 75% lived with the patient, 11% made multiple visits daily, 5% visited once daily and 9% visited less than once daily.

Not all high-acuity care models are created equal, but this research underscores the benefits and feasibility of home-based care. While concerns about caregiver stress are understandable, this study suggests that in-home care for qualified patients with appropriate conditions often provides a better caregiver experience in a more relaxed, convenient and less taxing environment than in traditional hospital settings.

“Home care elevates the quality of life across the board,” Kneeland said. “Whether it’s being surrounded by loved ones, keeping pets nearby, or creating a care plan that fits the patient’s day-to-day reality. It’s about making care more personal and realistic, which patients and caregivers appreciate the most.”