Objectives
To assess patient and caregiver perceptions of what constitutes quality care in home-based primary care (HBPC).
Design
Cross-sectional qualitative design; semi-structured interview study.
Setting
Academic home-based primary care program.
Participants
13 homebound patients and 10 caregivers receiving HBPC.
Measurements
Semi-structured interviews explored experiences with a home-based primary care program and perceptions of quality care. Interviews were audio-recorded and transcribed. Qualitative content analysis was performed to identify major themes.
Results
Five major themes emerged related to participant perceptions of quality care: access, affordability, competency, care coordination, and goal attainment. Participants felt reliable, consistent access provided “peace of mind” and reduced hospital and emergency room utilization. Insurance coverage of program costs and coordinated care provided by an interdisciplinary team were positively regarded. Interpersonal skills and technical abilities of providers influenced patient perception of provider competency. Assessing and helping patients attain care goals contributed to perceived quality care.
Conclusion
Patients and caregivers associate high-quality HBPC with 24/7 access to affordable interdisciplinary providers with strong interpersonal skills and technical competency. These results expand on prior research and are concordant with HBPC goals of 24/7 access to multidisciplinary teams with the goals of reduced emergency and hospital utilization. HBPC programs should be structured to optimize access, affordability, coordinated care, and goal ascertainment and alignment. Quality indicators should be created and validated with these patient and caregiver views of care quality in mind.
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