Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 2;20(6):e0323679.
doi: 10.1371/journal.pone.0323679. eCollection 2025.

Hospital-at-home care in Singapore: A qualitative exploration of health system partners' state of readiness, and policy and implementation strategies essential to support scale-up

Crystal Min Siu Chua  1   2 , Eward Wei Zheng Lim  1 , Win Hon See Tho  1 , Yuka Asada  3 , Karen E Peters  3 , Yi Feng Lai  1   2   3
Affiliations

Hospital-at-home care in Singapore: A qualitative exploration of health system partners' state of readiness, and policy and implementation strategies essential to support scale-up

Crystal Min Siu Chua et al. PLoS One. .

Erratum in

Abstract

Rationale: Many Hospital-at-Home (HaH) programs have proliferated in recent years to cope with the increasing demands of an ageing population and global hospital bed shortages. Singapore has implemented its own version, Mobile Inpatient Care at Home (MIC@Home). However, many HaH programs remain small, raising concerns about their scalability. Hence, a clear implementation strategy is needed.

Objectives: To address: (1) What is the readiness of Singapore's health system partners to scale up MIC@Home? and (2) What multi-level strategies are necessary for the successful scaling of MIC@Home in Singapore?.

Methods: A descriptive qualitative study design was used. Through purposive sampling, 32 participants (16 HaH clinicians, 11 enabling units, and 5 regulators) were recruited and semi-structured interviews were conducted. The interviews were transcribed using Trint and thematically analysed using Atlas.ti via Braun and Clarke's six-step inductive approach. This analysis was guided by the Health Policy and Partnership Readiness Assessment Framework.

Results: The key themes were: (1) perceived readiness to scale, focusing on stakeholder motivation and capacity; (2) implementation strategies, highlighting the need for training, collaborations, and operational refinements; and (3) policy strategies, addressing financial sustainability, governance, and regulation. MIC@Home is seen as a viable solution to acute bed shortages, with high readiness for scaling. Effective governance requires stakeholder buy-in, organizational alignment, partnerships, and adequate manpower. Regulatory strategies should be adjusted to sustain MIC@Home and improve patient access. For service provision, standardized guideline and data is vital to prove MIC@Home's effectiveness and safety, while convincing clinicians and patients of its value will increase acceptability. Finally, refining governance and establishing regulations for minimum care standards will support smooth operations and long-term success.

Conclusion: Despite the challenges of scaling MIC@Home, the findings underscore the potential of MIC@Home to enhance healthcare delivery through identifying readiness and strategies to position MIC@Home as an alternative to traditional care.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Overview of Interview findings.
Fig 2
Fig 2. Perception of stakeholders’ readiness to scale MIC@Home.
Fig 3
Fig 3. Implementation strategies uncovered through qualitative interviews.
Fig 4
Fig 4. Implementation strategies uncovered through qualitative interviews.
Fig 5
Fig 5. Policy strategies uncovered through qualitative interviews.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Howell JD. Hospitals. Medicine in the Twentieth Century: Taylor & Francis; 2020. p. 503–18.
    1. Low LL, Vasanwala FF, Ng LB, Chen C, Lee KH, Tan SY. Effectiveness of a transitional home care program in reducing acute hospital utilization: a quasi-experimental study. BMC Health Serv Res. 2015;15:100. doi: 10.1186/s12913-015-0750-2 - DOI - PMC - PubMed
    1. Lim WS, Wong SF, Leong I, Choo P, Pang WS. Forging a Frailty-Ready Healthcare System to Meet Population Ageing. Int J Environ Res Public Health. 2017;14(12):1448. doi: 10.3390/ijerph14121448 - DOI - PMC - PubMed
    1. Edgar K, Iliffe S, Doll HA, Clarke MJ, Gonçalves-Bradley DC, Wong E, et al. Admission avoidance hospital at home. Cochrane Database Syst Rev. 2024;3(3):CD007491. doi: 10.1002/14651858.CD007491.pub3 - DOI - PMC - PubMed
    1. Wallis JA, Shepperd S, Makela P, Han JX, Tripp EM, Gearon E, et al. Factors influencing the implementation of early discharge hospital at home and admission avoidance hospital at home: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2024;3(3):CD014765. doi: 10.1002/14651858.CD014765.pub2 - DOI - PMC - PubMed