Observational studyJournal of the American Geriatrics Society2026
Caregiver Burden at the Onset of Acute Hospital-At-Home.
Observational study in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundCaregiver burden at the onset of acute Hospital-at-Home (HaH) episodes, particularly in programs where caregiver availability is required for admission, remains insufficiently characterized in real-world settings. PARTICIPANTS AND
settingCaregivers of patients admitted to an acute HaH program within Clalit Health Services, Northern District, Israel, between 2023 and 2024.
methodsWe conducted a cross-sectional observational study of 125 caregivers assessed within the first 48 h of the HaH episode. Caregiver burden was measured using the Caregiver Strain Index (CSI; range 0-13), with high burden defined as CSI ≥ 7. Structured telephone interviews collected caregiver demographics, caregiving context, health-related quality of life (EQ-5D-5L; UK value set), resilience (CD-RISC-2), and perceived social support. Associations with high burden were examined using bivariate analyses and hierarchical logistic regression.
resultsHigh caregiver burden was present in 77 caregivers (61.6%) within the first 48 h of the HaH episode. Prior caregiving experience was more prevalent among caregivers with high burden than among those with low burden (97.4% vs. 50.0%, p < 0.001). High burden was also associated with anxiety/depression on the EQ-5D-5L (63.6% vs. 29.2%, p < 0.001), lower resilience (52.0% vs. 79.2%, p = 0.002), and lower perceived social support (59.7% vs. 83.3%, p = 0.006). In multivariable analysis, perceived social support (OR 0.22, 95% CI 0.06-0.74) and high resilience (OR 0.33, 95% CI 0.11-0.95) were associated with lower odds of high burden, whereas paid caregiver assistance was associated with higher odds of high burden (OR 5.23, 95% CI 1.17-23.37).
conclusionsHigh caregiver burden is common at the onset of acute HaH care. These exploratory findings suggest that caregiver vulnerability at admission is related to pre-existing caregiving context and psychosocial resources, supporting systematic caregiver assessment early in the HaH episode to identify individuals who may benefit from targeted support.
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