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Carson Moss



Job Title

Medical Student

Academic Rank




Carson T Moss, David M Levine

Principal Investigator

David Levine, MD, MPH, MA

Research Category: PCERC/Health Policy/Outcomes


Family caregiver burden in a home hospital versus traditional hospital: A secondary analysis of a randomized controlled trial

Scientific Abstract

Background: Knowledge of the impact on family caregivers within home hospital (HH) remains understudied. We aimed to identify the burden attributable to caregiving at home compared to the hospital.
Methods: We performed a retrospective analysis of prospective data from a randomized controlled trial, with participants in either HH or traditional hospitalization. On admission and discharge, family caregivers completed the Zarit Burden Interview-12 (ZBI-12), ranging from 0-48; 20, high burden.
Results: Overall, 91 patients were enrolled; 33 (36.3%) had complete caregiver data. Caregivers in HH (n=22) had a median ZBI-12 of 9.5 (IQR=4.75) on admission and 9.5 (IQR=10.75) on discharge compared to the control group (n=11) with a median of 15.0 (IQR=11.5) on admission and 8.0 (IQR=10.5) on discharge. There was no significant change in burden within HH (-0.5, p=0.25) or control (-2.0, p=0.088), between groups (p=0.33), nor associations with caregiver demographics.
Conclusions: Caregiver burden is mild-to-moderate upon admission and discharge in both groups, without significant change between groups. Our study is reassuring against a large difference in caregiver burden effected by HH participation. These findings suggest that HH programs are a viable alternative for acutely ill patients with caregivers.

Lay Abstract

Sometimes when patients are sick, they need the hospital. With special home hospital programs, hospital-level care can be done at home. We wanted to find out if family caregivers are burdened (or stressed) when their loved one gets hospital-level care at home vs the hospital.
We studied data where patients were by chance given care in the hospital or the home. Family caregivers completed a questionnaire called the “Zarit Burden Interview,” which measures the overall burden experienced by caregivers. We compared the scores between the 2 groups.
In total, 91 patients were enrolled, and 33 had complete caregiver data. The measured caregiver burden at the beginning and end of the study were similar for both groups, and there was no burden change in either group. Also, we did not find an association between burden and caregiver sex, relationship to the patient, or living situation.
Overall, caregivers in both groups had mild-to-moderate burden that did not change whether patients were in a home hospital or a traditional hospital. Our study shows some evidence that caregivers do not become overburdened, or overstressed, when their loved ones receive hospital-level care at home.

Clinical Implications

Our findings alleviate concerns that family caregivers may be more burdened when their acutely ill loved one is cared for at home versus in the hospital.