Older persons’ experiences of receiving emergency department-level care at home from a mobile healthcare team in Sweden - a qualitative interview study

Abstract Background: The demand for acute care among older persons is increasing, and home-based care models have gained attention as safer, more person-centred alternatives that support independence and well-being in familiar surroundings. In Sweden, mobile healthcare teams provide emergency department-level care in patients’ homes, offering timely and individualised medical interventions. While such services are considered effective and valued by healthcare professionals, there is limited knowledge about patients’ experience of acute care at home, which is the aim of the current study. Methods: The study employed a qualitative content analysis and inductive design. Data were collected through semi-structured interviews with older persons (≥75 years) who had received emergency department-level care at home from a mobile healthcare team in a region in the west of Sweden. A total of 29 individuals were interviewed between July 2022 and January 2023. Results: Four overarching themes emerged from the analysis: 1) the meaning of environment in acute care delivery, 2) the importance of person-centred encounters, 3) balancing needs, wishes and prior experiences during the acute care episode and 4) the value of mobile healthcare teams as an alternative care pathway. Participants described home as a safe and comfortable setting, contrasting sharply with past negative experiences from the emergency department. They valued the personal, respectful and attentive care provided by mobile healthcare teams, which promoted trust and offered emotional reassurance. The ability to receive care on their own terms – with the support of family caregivers when needed – contributed to a sense of autonomy. Mobile healthcare teams were seen as a flexible and effective alternative to hospital care, although some participants noted limitations related to available diagnostics. Conclusions: This study provides new insights into older persons’ experiences of receiving emergency department-level care at home. The findings suggest that mobile healthcare is perceived as a safe, person-centred and preferable alternative to hospital care. Key elements included the familiar home environment and respectful, competent interactions with healthcare professionals. The results support broader integration of mobile healthcare and highlight the need for further research on outcomes, patient selection and implementation on a system level. Trial registration: This clinical trial was registered 2022-01-17 in the project database for research and development (R&D) in the Vastra Gotaland region (Reg. no: 277735).