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 Jul 1;25(1):875.
doi: 10.1186/s12913-025-12935-y.

Facilitators and barriers to provision of hospital in the home: does geographical location matter? A scoping review

Kristen Glenister  1 , Ryan L McGrath  2   3   4 , Rowan O'Hagan  2   5 , Ka Chun Tse  6 , Jennifer Keast  2   7 , Lucinda Aberdeen  2
Affiliations

Facilitators and barriers to provision of hospital in the home: does geographical location matter? A scoping review

Kristen Glenister et al. BMC Health Serv Res. .

Abstract

Background: There is an increasing imperative for hospital services delivered in the home due to overburdened hospital systems, ageing populations and rising prevalence of chronic disease. Hospital in the home services have numerous advantages including reduced mortality, reduced hospital readmission and emergency department presentations and improved patient quality of life. Despite anticipated benefits for rural communities, which typically experience high prevalence of chronic disease and high rates of potentially avoidable hospitalisation, there appears to be limited research that focusses specifically on the provision of hospital in the home care in rural areas.

Methods: The aim of this scoping review was to identify facilitators and barriers to the provision of hospital in the home services in rural areas. A scoping review of literature published in English between 1990 and 2023 was conducted using Medline and EMBASE. A key term search strategy was employed using 'hospital in the home' and 'rural' plus equivalent search terms. Inclusion criteria primarily focused on articles that described acute, in-patient bed substitution for adult patients.

Results: Thirty-five articles met the inclusion criteria. These articles were diverse in terms of methodology, models of care, patient populations and country of origin. Many facilitators and barriers to the provision of hospital in the home were not necessarily specific to rural contexts, for example, workflows and patient selection. Rural specific facilitators included rurally tailored models of care, and rural community strengths such as resourcefulness, social capital and reciprocity. Conversely, rural specific barriers included travel distances and associated costs, complicated by challenging weather conditions or terrain.

Conclusion: Whilst the evidence base for provision of hospital in the home care in rural areas was limited, consideration of the facilitators and barriers identified in this review should assist with the provision of hospital in the home services in rural areas.

Keywords: Home; Hospital at home; Rural.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) diagram of scoping review
Fig. 2
Fig. 2
Map of included studies
See this image and copyright information in PMC

References

    1. Molyneux J. What’s the future of hospital at home in the united States? Am J Nurs. 2023;123(2):20–2. - PubMed
    1. Pandit JA, Pawelek JB, Leff B, Topol EJ. The hospital at home in the USA: current status and future prospects. NPJ Digit Med. 2024;7(1):48. - PMC - PubMed
    1. Montalto M, McElduff P, Hardy K. Home ward bound: features of hospital in the home use by major Australian hospitals, 2011–2017. Med J Aust. 2020;213(1):22–7. - PubMed
    1. Lim SM, Island L, Horsburgh A, Maier AB. Home first! Identification of hospitalized patients for Home-Based models of care. J Am Med Dir Assoc. 2021;22(2):413–e71. - PubMed
    1. Paulson MR, Shulman EP, Dunn AN, Fazio JR, Habermann EB, Matcha GV, et al. Implementation of a virtual and in-person hybrid hospital-at-home model in two geographically separate regions utilizing a single command center: a descriptive cohort study. BMC Health Serv Res. 2023;23(1):139. - PMC - PubMed

Publication types

LinkOut - more resources