Hospital Homebound Students and K-12 Online Schooling: A Cross-Sectional Analysis (Preprint)

BACKGROUND The United States public educational system encourages inclusion, integrating learners with different needs in the same classroom students, including those with chronic disability and illness. However, a small but significant number of students with chronic illnesses or disabilities may not be healthy enough to attend school in a traditional environment. Hospital homebound programs serve these children by providing educational instruction for those living with short-term and chronic disabilities in non-school settings. These programs are publicly supported, differing significantly from homeschooling where, traditionally, a child’s parent or guardian assumes responsibility for the delivery of educational services. The limited research exploring hospital homebound programs describes them as challenged, characterized by instructors who may lack the qualifications to teach critical core subject matters and teach with limited instructional time. As online learning continues to become more mainstream in the United States, it is important to explore the impact that the medium could have on students with differing needs. The flexibility afforded by online education may provide opportunities for learners with disability that necessitates absence from traditional learning environments. OBJECTIVE This study sought to describe how a subset of learners with disability, those with a hospital-homebound designation, perform in K-12 online classes, particularly as compared to non-hospital homebound counterparts. METHODS A cross-sectional analysis was performed of all Florida Virtual School course enrollments from August 1, 2012, to July 31, 2018. Researchers analyzed 2,534-course enrollments associated with students who, at the time of their course enrollment, had hospital-homebound designation, and a comparison group of 5,470,591 enrollments from students without hospital-homebound status. RESULTS Hospital-homebound designed student academic performance was equivalent to their non-hospital homebound counterparts (P = .05 - .28). But, hospital-homebound course enrollments were 26% more likely to result in a withdrawal prior to grade generation (P < .01). CONCLUSIONS Hospital-homebound students represent a population under-served by many education systems, including online education. The results of this study provided evidence that when they can remain enrolled, hospital-homebound learners experience equivalent academic outcomes in online learning environments. These findings suggest that healthcare professionals should be made aware of the potentially equivalent outcomes for their patients, and virtual schools should seek to identify and create supports for these students.