Validating a taxonomy of hospital at home (HaH) care models: An eDelphi study

Background Hospital at home (HaH) is a model of acute healthcare that delivers hospital-level medical, nursing, and allied health services to patients in their own homes as a substitute for traditional hospital admission. The aim of this adapted Delphi study was to collect researcher’s opinions on a taxonomy for HaH care models. Methods We invited researchers with experience in HaH care to judge the relevance of items of a HaH taxonomy developed in previous work. In all three rounds, the participants scored the relevance of the characteristics regarding describing HaH care models on a 5-item Likert scale. Free text comments could be provided to each characteristic in all three rounds. Results Twenty persons joined the first round and sixteen persisted to the final round. 63 characteristics out of 90 achieved consent of which 27 obtained a strong agreement. The final taxonomy comprises 60 characteristics for 11 dimensions which in turn are aggregated into 5 perspectives. The results indicate that experts largely agree on metrics. Consensus is broad for many characteristics related to clinical characteristics. Patient-facing technology and also ecological sustainability as outcome seem to be less relevant currently. Conclusions The provided taxonomy can be used as checklist when new HaH care programs are developed to ensure key components are considered and reflected (e.g., patient eligibility, clinical services, technology use). It can be used as starting point for developing new HaH care models or updating existing ones. It provides also guidance for quality assessment.