High Patient Satisfaction in a Telemedicine-Based Virtual-First Hospital-at-Home Program: A Large Real-World Cohort Study

BACKGROUND: Hospital-at-Home (HaH) programs supported by telemedicine have emerged as a promising alternative to conventional hospitalization. However, evidence on patient experience in large-scale, real-world virtual-first models remains limited. The objective of this research was to evaluate patient experience and satisfaction in a telemedicine-based, virtual-first HaH program. METHODS: We conducted a retrospective observational cohort study, including adult patients admitted to a virtual-first HaH program at a tertiary hospital in Madrid, Spain, between October 2020 and May 2025. Patient experience was assessed at discharge using a routinely implemented digital questionnaire. A set of 18 common items across questionnaire versions was analyzed, covering communication, perceived safety, professional competence, and overall satisfaction. Responses were standardized and dichotomized using a top-box approach. RESULTS: A total of 887 patients were included (median age 64 years; median length of stay 9 days). Patient experience was highly positive, with satisfaction rates exceeding 95% across most domains. Perceived safety was reported by 98.98% of patients, and 97.06% indicated that telemedicine was easily integrated into daily life. Overall satisfaction reached 96.50%, and the same proportion would choose the HaH model again. CONCLUSIONS: A telemedicine-based, virtual-first HaH program achieved very high levels of patient satisfaction and perceived safety in a large real-world cohort. These findings support the feasibility and acceptability of virtual-first models for acute hospital care, demonstrating consistent patient experience across diverse clinical profiles, age groups, and lengths of stay.