Saving money, costing women: the gendered price of hospital-at-home

Marie-Eve Laporte (), Clotilde Coron () and Patrick Gilbert ()
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Marie-Eve Laporte: RITM - Réseaux Innovation Territoires et Mondialisation - Université Paris-Saclay, Université Paris-Saclay
Clotilde Coron: Université Paris-Saclay
Patrick Gilbert: IAE Paris - Sorbonne Business School

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Abstract: Hospital-at-Home (HaH) is increasingly promoted as a patient-centered and cost-effective alternative to conventional hospitalization. While its clinical and organizational benefits are well documented, less attention has been paid to the forms of work on which HaH relies and to their gendered implications. This article examines HaH as a situation where paid healthcare work is transformed into unpaid caregiving work, and analyzes how this process reinforces gender inequalities.The study draws on an ethnographic case study conducted over eighteen months in one of France's largest HaH institutions, combining 120 h of observation, 27 semi-structured interviews with healthcare professionals, managers, family caregivers, and user representatives, and secondary documentary sources. The findings show, first, that family caregivers perform unpaid work that substitutes for professional care and displays all the defining features of work. Second, this work produces gender-differentiated effects: women caregivers were more often involved in multiple caregiving configurations and more frequently had to articulate care with paid employment, domestic work, and other family responsibilities, creating cumulative pressures on their time, health, and professional trajectories. Third, HaH is underpinned by gendered norms that naturalize women's caregiving capacities and render men's involvement more visible and exceptional, contributing to the invisibilization of women's unpaid work.By foregrounding the gendered costs of HaH, this article contributes to debates on health system reforms and care work in gender studies, and highlights the tensions between cost-containment policies in healthcare and gender equality objectives.

Keywords: system reforms; Gender Health; Unpaid work; Family caregivers; Hospital-at-Home (search for similar items in EconPapers)
Date: 2026-08
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Published in Social Science & Medicine, 2026, 407, pp.119661. ⟨10.1016/j.socscimed.2026.119661⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:halshs-05725173

DOI: 10.1016/j.socscimed.2026.119661

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