There is no place like home: patient perspectives on mobility outside the home during hospital-at-home care– a qualitative study

BACKGROUND: Hospital-at-Home (HaH) has emerged as an alternative to conventional inpatient care by delivering hospital-level treatment in patients' homes. While Hospital-at-Home may support recovery in familiar surroundings, uncertainty remains regarding whether patients should engage in activities outside the home while still receiving hospital-level care. PURPOSE: This study explored patients' perspectives on mobility outside the home during home hospitalization, including perceived benefits, limitations, responsibilities, and practical considerations associated with community activities. MATERIALS AND METHODS: A qualitative study involving in-depth semi-structured interviews was conducted with 25 participants enrolled in a Hospital-at-Home programme in Singapore. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. RESULTS: Three themes and six subthemes were identified: (1) navigating mobility during recovery (individual health considerations; family and caregiver support); (2) importance of venturing outside the home (emotional well-being and health benefits; maintaining normal routines); and (3) balancing autonomy and accountability (accountability; arrangements for community leave). Participants viewed venturing outside the home as beneficial for recovery, emotional well-being, and maintaining normal daily activities. Mobility decisions were influenced by health status, available support, and practical considerations regarding communication with healthcare teams. CONCLUSION: Patients viewed mobility outside the home as an important component of recovery during home hospitalization. Rather than perceiving autonomy and safety as competing priorities, participants described balancing independence with personal responsibility and ongoing communication with healthcare teams. These findings may inform the development of patient-centred mobility approaches in Hospital-at-Home programmes while highlighting the need for adaptation in populations with frailty or increased care needs.