Designing Care Beyond the Hospital: Revealing Hidden Care Demands in Hospital-At-Home Services.
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| Title: | Designing Care Beyond the Hospital: Revealing Hidden Care Demands in Hospital-At-Home Services. |
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| Authors: | Rai, Ranvir S.1 (AUTHOR) ranvir.rai@kristiania.no |
| Source: | Inquiry (00469580). 7/3/2026, Vol. 63, p1-11. 11p. |
| Subject Terms: | *Occupational roles, *Qualitative research, *Diffusion of innovations, *Decision making, *Research methodology, *Caregiver attitudes, Home care services, Health literacy, Digital health, Interviewing, Judgment sampling, Thematic analysis, Burden of care, Patient-centered care, Videoconferencing, Attitudes of medical personnel, Medical needs assessment, Patients' attitudes |
| Geographic Terms: | Norway |
| Abstract: | Background: Hospital-at-home (HaH) services are increasingly implemented as digitally supported alternatives to inpatient care. While these models promise efficiency, continuity, and patient-centredness, they also redistribute responsibility from healthcare organisations to patients and family caregivers. This shift introduces health literacy demands related to timing, role clarity, and digitally mediated decision-making, which remain underexplored in digital health research. Methods: This qualitative study draws on ten in-depth interviews with patients, family caregivers, and healthcare professionals involved in hospital-at-home services in Norway. Interviews examined experiences of decision-making, remote monitoring, coordination, and follow-up in digitally supported home-based care. Following inductive thematic analysis, a service blueprint was developed as an analytical synthesis to examine how care demands and responsibilities were distributed across the service trajectory. Results: Caregiver burden was shaped less by individual capability than by service configurations that assumed high levels of availability, confidence, and digital competence. Family caregivers frequently assumed quasi-clinical and coordinative roles without adequate preparation or support. Health literacy demands clustered at key transitions, including decision-making, at-home monitoring, and discharge, where digital tools mediated responsibility and risk. These demands accumulated over time, generating vulnerabilities related to equity and sustainability. Conclusion: Digitally supported HaH services rely on implicit assumptions about patients' and caregivers' capacity to manage care at home. Design-informed analysis can reveal transition-located health literacy demands and digitally mediated responsibility shifts, supporting more inclusive and resilient digital health service models. [ABSTRACT FROM AUTHOR] |
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| Database: | Education Research Complete |
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| Abstract: | Background: Hospital-at-home (HaH) services are increasingly implemented as digitally supported alternatives to inpatient care. While these models promise efficiency, continuity, and patient-centredness, they also redistribute responsibility from healthcare organisations to patients and family caregivers. This shift introduces health literacy demands related to timing, role clarity, and digitally mediated decision-making, which remain underexplored in digital health research. Methods: This qualitative study draws on ten in-depth interviews with patients, family caregivers, and healthcare professionals involved in hospital-at-home services in Norway. Interviews examined experiences of decision-making, remote monitoring, coordination, and follow-up in digitally supported home-based care. Following inductive thematic analysis, a service blueprint was developed as an analytical synthesis to examine how care demands and responsibilities were distributed across the service trajectory. Results: Caregiver burden was shaped less by individual capability than by service configurations that assumed high levels of availability, confidence, and digital competence. Family caregivers frequently assumed quasi-clinical and coordinative roles without adequate preparation or support. Health literacy demands clustered at key transitions, including decision-making, at-home monitoring, and discharge, where digital tools mediated responsibility and risk. These demands accumulated over time, generating vulnerabilities related to equity and sustainability. Conclusion: Digitally supported HaH services rely on implicit assumptions about patients' and caregivers' capacity to manage care at home. Design-informed analysis can reveal transition-located health literacy demands and digitally mediated responsibility shifts, supporting more inclusive and resilient digital health service models. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00469580 |
| DOI: | 10.1177/00469580261466643 |
