Perceptions of home hospitalization among the public and physicians in Israel: findings from surveys conducted for the Dead Sea Health Policy Conference of 2022.

Abstract

Background: Hospital at Home (HaH) is an alternative care model that provides acute hospital-level services to patients at their homes. Despite its proven advantages and global experience, HaH did not gain significant traction in Israel until the COVID-19 pandemic. The issue was highlighted at the 2022 Dead Sea Conference on Health Policy. This study compares perceptions of HaH among the Israeli public and physicians, Jewish and Arab, identifying facilitators and barriers to its expansion in Israel.

Methods: Two online surveys were conducted, one with 342 physicians and another with 424 members of the public aged 35+. Respondents were sampled based on age, gender, district of residence, and population group. Descriptive statistics and chi-square tests explored perceptions, and logistic regression analyzed multivariate relationships.

Results: Results showed 39% of the public believed HaH care quality is as good as or better than hospitals, compared to 65% of physicians. 44% of the public felt HaH safety is as good or better, while 75% of physicians agreed. 58% of the public saw communication between patients/families and the healthcare professionals in HaH as good or better, contrasted with 91% of physicians. 78% of the public and 97% of physicians viewed HaH as a good alternative to hospitalization and would consider using it personally. Arab and lower-income respondents were less positive about HaH than Jewish and higher-income respondents. Community-based physicians preferred HaH more than hospital-based ones. Barriers to HaH expansion included lack of specialized manpower, resources, and awareness.

Conclusions: The findings suggest that both the public and physicians show confidence in HaH, and it is gaining popularity among both. Policymakers could use these insights to expand HaH, focusing on increasing awareness, reducing family burden, tailoring services for diverse populations, involving hospital staff, and investing in resources and training.