Influences of COVID-19 pandemic on hospital-at-home functions in Finland – a questionnaire survey

Figures & data

Figure 1. Basic structure of the HAH model in primary health care in Finland [17]. The arrowed lines present the flow of patients. Indications for eligibility and criteria for exclusion for HAH are given in the boxes. Main target is to produce care for adult patients otherwise requiring inpatient ward care and palliative care services. *Calling list includes patients, who are registered to a HAH but do not need regular visits to home. Some HAHs may also provide outpatient unit for policlinic visits. AC: advanced care planning; EOL: end-of-life.

Table 1. Activities of HAHs in Finland in 2019 and 2020. HAH = number of the responding HAH.

HAH	Part	Size	Patients 2019	Patients 2020	Activity 2019	Activity 2020	Act/pt 2019	Act/pt 2020	EOL 2019	EOL 2020	Deaths 2019	Deaths 2020
1	South	C	1500	1750	16,500	17,200	11	10	120	150	75	100
2	South	C	2049	1912	9893	9382	5	5	469	504	26	24
3	West	C	1014	1219	9872	12,382	10	10	–	–	–	–
4	West	B	708	708	10,497	9060	15	13	–	52	–	39
5	Middle	C	642	575	11,933	11,709	19	20	347	310	52	79
6	Middle	C	3167	2979	22,689	20,137	7	7	–	–	–	–
7	East	B	893	852	10,309	10,799	12	13	159	170	32	49
8	East	B	545	679	4450	4764^a	8	7	46	57	13	15
9	North	B	640	570	11,933^a	11,808	19	21	320	285	52	79
10	North	A	642	601	3524^a	3714^a	5	6	30	40	16	20
	Median		844	800	10,403	11,254	10	10	139	150	29	44

Part: location of the HAH in Finland. Size: Population of the catchment area: A = < 50,000; B = 50–100,000; C) > 100,000. N 2019/2020: numbers of patients in 2019/2020.

^aActivity 2019/2020: number of patient visits or days of care.

Act/pt: activity per patient; EOL 2019/2020: numbers of patients in EOL care 2019/2020; Death 2019/2020: numbers of death in home-based EOL care

Table 2. Median (range) numbers of nurses and physicians and HAHs with availability of staff and COVID-19-related actions.

Variable	2019	2020
NNurs	15 (5–29)	17 (7–29)
NPhys	1 (0.5–3)	1 (0.5–4)
Diff Nurs		1/4/5
Diff Phys		0/6/3
Staff on sick-leave		6/2/0
Corona sampling (N/Y)		2/8
Attitude changes (N/Y)		8/2

NNurs: number of nurses; NPhys: number of physicians; Diff Nurs: difficulties to get nurses: numbers of HAHs with no/no changes/more difficult than in 2019; Diff Phys: difficulties to get physicians: numbers of HAHs with no/no changes/more difficult than in 2019; Staff on sick-leave: numbers of hospitals with < 30/30–50/>50% on sick-leave at the most; corona sampling: numbers of HAHs where corona virus samples were taken by nurses on not; attitude: observed changes in patients’ attitudes on HAH.

N: no; Y: yes

Table 3. Finnish classification of the severity of COVID-19 pandemics.

State of pandemic	Definition
Basic state	incidence is low local and regional chains of infections can be traced effectively significant spread of infection is not detected outside the chains new cases are sporadic or in the quarantines
Acceleration: epidemics are accelerating from the baseline	the regional incidence of infections is > 10–25 per 100,000 persons over a period of 14 d. local and regional transmission chains are largely traceable there is sufficient capacity to respond to the need for hospital care without special measures
Spreading phase: infections are spreading at the regional level or more broadly throughout the population, tracing is not possible	incidence of > 18–50 infections per 100,000 persons over 14 d. increase in daily incidence rate > 10%. < 50% sources of infection are traceable, the need for hospital care and intensive care is growing sharply

Ohvanainen A, Niemi-Murola L, Elonheimo O, et al. Hospital-at-home network in Finland. Int J Healthc Manage. 2020;14:1018–1024.

 Web of Science ®Google Scholar