Families’ Degree of Satisfaction With Pediatric Telehomecare: Interventional Prospective Pilot Study in Catalonia

Abstract

Background Pediatric home hospitalization improves the quality of life of children and their families, involving them in their children’s care, while favoring the work-life balance of the family. In this context, technology guarantees accessibility to assistance, which provides security to users. From the perspective of the health care system, this could lower the demand for hospital services and reduce hospitalization costs. Objective This study aimed to assess families’ degree of satisfaction and acceptability of pediatric telehomecare and explore the clinical characteristics of children benefiting from the program. Methods A total of 95 children and their families participated in the home-hospitalization pilot program operated by Sant Joan de Déu Hospital in Barcelona, Spain. Families were visited once a day and patients were monitored using a kit consisting of a scale, a thermometer, a pulse oximeter, and a blood pressure monitor. Data on parental experience, satisfaction, safety, and preference for care was collected by means of a questionnaire. Data about the children’s characteristics were collected from medical records. Descriptive and comparative statistics were used to analyze the data. Results A total of 65 survey respondents expressed very high levels of satisfaction. Families reported their experiences as being very positive, preferring home hospitalization in 94% (61/65) of cases, and gave high scores regarding the use of telemonitoring devices. The program did not record any readmissions after 72 hours and reported a very low number of adverse incidents. The user profile was very heterogeneous, highlighting a large number of respiratory patients and patients with infections that required endovenous antibiotic therapy. Conclusions Pediatric home hospitalization through telemonitoring is a feasible and desirable alternative to traditional hospitalization, both from the perspective of families and the hospital. The results of this analysis showed a very high degree of satisfaction with the care received and that the home-based telemonitoring system resulted in few adverse incidents.

Patient and clinician use characteristics and perceptions of pulse oximeter use: A scoping review

“…Seven studies (43.8%) [8] , [9] , [10] , [11] , [12] , [13] , [14] were intervention studies that introduced a new telehealth system that included a pulse oximeter and gathered user experience feedback. Two studies were case studies assessing the usability of a pulse oximeter in a healthcare context [15] , [16] .…”

“…Four of the included studies (25%) examined the use of pulse oximeters as a tool to increase availability of care through pairing with a smartphone application [17] , [18] , [19] , [20] . Other applications included: as a diagnostic tool for children with pneumonia [15] , [16] ; a monitoring tool in paediatric telehomecare [11] ; remote risk-based monitoring tool for patients at risk of Cardiovascular disease (CVD) [8] , [10] ; a general monitoring tool for blood oxygenation levels [21] , [22] ; post-operative continuous vital sign monitoring for patients recovering from surgery [14] ; data capture and transmission to streamline clinical trials [9] ; long-term oxygen therapy (LTOT) optimization [12] ; and as a digital health intervention for managing Chronic Obstructive Pulmonary Disease (COPD) patients, either as a diagnostic tool or during rehabilitation [4] , [13] .…”

Pediatric Tele–Home Care Compared to Usual Care: Cost-Minimization Analysis

“…For example, a recent systematic review that focuses on malignant and nonmalignant hematology concluded telemedicine provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations [ 29 ]. The readmission rate for home care was not significantly higher than for hospital care [ 20 ]. Additionally, in terms of satisfaction, a British study shows that 90% of parents and 63% of children stated a clear preference for home hospitalization, citing less psychosocial disruption and a perception that children recover more quickly with comfortable surroundings [ 11 ].…”

“…The intervention and characteristics of the families who used the service has been documented in previous studies [ 20 ]. When the care team, whether from the hospitalization ward, outpatient department, or emergency department, detects a potential case of hospitalization at home, it contacts the referent of this program, which evaluates it according to the inclusion criteria (30 minutes of isochronous, clinical stability, voluntary consent, and adequate living conditions in the home).…”

“…Furthermore, prior reporting states that experiences are positive [ 12 - 19 ]. After the success of the pilot program, with families preferring home hospitalization in 94% (61/65) of cases [ 20 ], “SJD a Casa” started operating in an ordinary way on November 1, 2019.…”