Gatekeepers to home and community care services: the link between client characteristics and source of referral

2013 ◽  
Vol 37 (3) ◽  
pp. 356 ◽  
Author(s):  
Nerina Vecchio
Keyword(s):  
Home Care ◽  
Community Care ◽  
Health Workers ◽  
Multinomial Logistic Regression ◽  
Care Program ◽  
Ageing Population ◽  
Community Factors ◽  
Care Services ◽  
Healthcare Needs ◽  
Home And Community Care

Objectives. To identify characteristics associated with the likelihood of a client receiving a referral to the Home and Community Care (HACC) program from various sources. Methods. Data were collected from 73 809 home care clients during 2007–08. Binary logistic and multinomial logistic regression were used to investigate the likelihood of a client being referred by health workers v. non-health workers. Results. Females and clients cared for by their parents were less likely to receive referrals from health workers than non-health workers after confounding variables were controlled for. While poorer functional ability of clients increased the probability of receiving a referral from a health worker, the opposite was true for those with behavioural problems. Over 43% of the sample either self-referred or was referred by family or friends. Conclusions. Eligible individuals may miss out on services unless they or their family take the initiative to refer. There is a need for improved methods and incentives to support and encourage health workers to refer eligible individuals to the program. What is known about the topic? The absence or inappropriate referral to a suitable home care program can place pressure on formalised institutions and increase burdens on family members and the community. Factors largely unrelated to healthcare needs carry significant weight in determining hospital discharge decisions and home care referrals by practitioners. What does this paper add? The effectiveness of the HACC program is dependent on the referrer who acts to inform and facilitate individuals to the program. The purpose of this study is to identify the characteristics associated with the likelihood of individuals receiving a referral to the HACC program from various sources. What are the implications for practitioners? This study will assist policy makers and practitioners in developing effective strategies that transition individuals to suitable home care services in a timely manner. An effective referral process would provide opportunities for implementing preventative strategies that reduce disability rates among individuals and the burden of care for the community. For instance, individuals with unmet needs may be at higher risk from injury at home through inadequate monitoring of nutrient and medication intake and inappropriate home surroundings. Improving knowledge about care options and providing appropriate incentives that encourage health workers to refer individuals would be an effective start in improving the health outcomes of an ageing population.

Improving Access to Home and Community Care: An Analysis of the 2017 Health Accord

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rhiannon Robertd ◽  
◽  
Mary Bartram ◽  
Katerina Kalenteridis ◽  
Amélie Quesnel-Vallée ◽  
...  
Keyword(s):  
Home Care ◽  
Community Care ◽  
Burden Of Care ◽  
Bilateral Agreements ◽  
Care Services ◽  
Home And Community Care ◽  
Canadian Health ◽  
Liberal Government ◽  
Federal Initiatives ◽  
Improve Access

In 2017, the federal Liberal government confirmed the new Canadian Health Accord, which included a targeted transfer of $6B over ten years to the provinces and territories to improve access to home and community care services. Although there were previous federal initiatives aimed at enhancing home and community care services, challenges remain. Many Canadians cannot access home care, and a high burden of care is placed on formal and informal caregivers. These challenges partly stem from an unregulated home care sector and a societal undervaluing of the caregiving role. In 2016, federal, provincial, and territorial governments met and established home and community care as a Canadian health priority. Funding was agreed to in principle from 2016 to 2017 and finalized from 2017 to 2019 through a series of bilateral agreements. The targeted transfer appears to be boosting investments in the home care sector and fostering collaboration across jurisdictions. However, it is unclear whether there have been improvements in access to home and community care.

scholarly journals MUTIARA HOME CARE

2018 ◽  
Vol 23 (4) ◽  
pp. 440
Author(s):  
Janno Sinaga ◽  
Amila Amila ◽  
Evarina Sembiring
Keyword(s):  
Home Care ◽  
Health Workers ◽  
Care Program ◽  
Home Care Services ◽  
Hospital Treatment ◽  
Care Services ◽  
National Economic ◽  
Care Of Elderly ◽  
Or Organization ◽  
The Cost

AbstrakTujuan jangka panjang pelaksanaan program Mutiara Home Care adalah menciptakan akses bagi terciptanya wirausaha baru, menunjang otonomi kampus perguruan tinggi melalui perolehan pendapatan mandiri. Bagi pasien program ini membantu meringankan biaya rawat inap yang makin mahal, karena mengurangi biaya akomodasi pasien, transportasi dan konsumsi keluarga. Dampak ekonomi nasional home care bagi pasien dan keluarga adalah semakin pendeknya hari rawat, sehingga jumlah klaim rumah sakit ke BPJS semakin rendah, sehingga berdampak bagi penurunan anggaran biaya perawatan masyarakat secara nasional. Produk Jasa Layanan Mutiara Home Care memiliki keunggulan dibandingkan home care lain. Pertama, Mutiara Home care akan dikelola dan diorganisir secara profesional oleh tenaga dosen profesional dibidang kesehatan dan keperawatan. Selama ini, home care dilakukan secara individu atau berkelompok tanpa wadah atau organisasi yang jelas. Tenaga kesehatan yang akan ditempatkan di komunitas atau di rumah telah terlatih dimulai sejak masa pendidikan dan tersertifikasi dari USM-Indonesia. Kedua, menyediakan layanan antar jemput pasien yang membutuhkan perawatan rumah sakit atau pemeriksaan khusus, seperti radiologi dan laboratorium. Layanan Mutiara Home Care pada tahap awal melayani pasien paska stroke dan perawatan lanjutan jantung, perawatan pasien DM dengan atau tanpa luka dan perawatan pasien lanjut usia. Secara bertahap akan dilakukan pengembangan serta layanan terhadap berbagai penyakit yang membutuhkan jasa perawatan profesional di rumah.Kata Kunci: Home care, MutiaraAbstractThe long-term goal of the Mutiara Home Care program is to create access to new entrepreneurs, to support college campus autonomy through the acquisition of independent income. For patients this program helps alleviate the cost of increasingly expensive hospitalization, as it reduces patient accommodation costs, transportation and family consumption. The national economic impact of home care for patients and families is the shortening of day care, so the number of hospital claims to BPJS is lower, thus impacting the reduction of national community maintenance budget. Products Care Services Pearl Home Care has advantages over other home care. First, Mutiara Home care will be managed and organized professionally by professional lecturers in the field of health and nursing. During this time, home care is done individually or in groups without a clear container or organization. Health workers who will be placed in the community or at home have been trained since the education and certified from USM-Indonesia. Secondly, it provides a shuttle service to patients who require hospital treatment or special examinations, such as radiology and laboratories. Pearl Home Care Services in the early stages of serving post-stroke patients and advanced heart care, treatment of DM patients with or without injuries and care of elderly patients. Gradually will be developed as well as services against various diseases that require professional care services at home.Keywords: Homecare, Mutiara

The Reform of Home Care Services in Ontario: Opportunity Lost or Lesson Learned?

2007 ◽  
Vol 74 (3) ◽  
pp. 208-216 ◽  
Author(s):  
Glen Randall
Keyword(s):  
Home Care ◽  
Physical Therapists ◽  
Critical Role ◽  
Care Program ◽  
Home Care Services ◽  
Rehabilitation Services ◽  
Hospital Discharges ◽  
Rehabilitation Professionals ◽  
Care Services ◽  
Commission Report

Background. With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. Purpose. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Method. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Results. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Practice Implications. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

Improving primary level home and community care services for older people: The case of Hong Kong

2017 ◽  
Vol 27 (1) ◽  
pp. 52-61 ◽  
Author(s):  
Yuan Yuan Fu ◽  
Ernest Wing Tak Chui ◽  
Wing Shan Kan ◽  
Lisanne Ko
Keyword(s):  
Hong Kong ◽  
Older People ◽  
Community Care ◽  
Primary Level ◽  
Care Services ◽  
Home And Community Care

Characteristics of older adults living with HIV accessing home and community care services in British Columbia, Canada

AIDS Care ◽  
2020 ◽  
Vol 33 (1) ◽  
pp. 121-130
Author(s):  
Katrina Koehn ◽  
Heather Burgess ◽  
Sharyle Lyndon ◽  
Michelle Lu ◽  
Monica Ye ◽  
...  
Keyword(s):  
Older Adults ◽  
British Columbia ◽  
Community Care ◽  
Care Services ◽  
Home And Community Care ◽  
Living With Hiv

scholarly journals P035: Impact of EMS direct referral to community care on emergency department utilization

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S75
Author(s):  
A. Dukelow ◽  
M. Lewell ◽  
J. Loosley ◽  
S. Pancino ◽  
K. Van Aarsen
Keyword(s):  
Emergency Department ◽  
Home Care ◽  
Community Care ◽  
Home Care Services ◽  
Emergency Department Visits ◽  
Emergency Department Utilization ◽  
Care Services ◽  
Significant Difference ◽  
Ed Visits ◽  
The Impact

Introduction: The Community Referral by Emergency Medical Services (CREMS) program was implemented in January 2015 in Southwestern Ontario. The program allows Paramedics interacting with a patient to directly refer those in need of home care support to their local Community Care Access Centre (CCAC) for needs assessment. If indicated, subsequent referrals are made to specific services (e.g. nursing, physiotherapy and geriatrics) by CCAC. Ideally, CREMS connects patients with appropriate, timely care, supporting individual needs. Previous literature has indicated CREMS results in an increase of home care services provided to patients. Methods: The primary objective of this project is to evaluate the impact of the CREMS program on Emergency Department utilization. Data for all CCAC referrals from London-Middlesex EMS was collected for a thirteen month period (February 2015-February 2016). For all patients receiving a new or increased service from CCAC the number of Emergency Department visits 2 years before referral and 2 years after referral were calculated. A related samples Wilcoxon Signed Rank Test was performed to examine the difference in ED visits pre and post referral to CCAC. Results: There were 213 individuals who received a new or increased service during the study timeframe. Median [IQR] patient age was 77 [70-85.5]. 113/213 (53%) of patients were female. The majority of patients 135/213 (63.4%) were a new referral to CCAC. The median [IQR] number of hospital visits before referral was 3 [1-5] and after referral was 2 [0-4]. There was no significant difference in the overall number of ED visits before versus after referral (955 vs 756 visits, p = 0.051). Conclusion: Community based care can improve patient experience and health outcomes. Paramedics are in a unique position to assess patients in their home to determine who might benefit from home care services. CREMS referrals for this patient group showed a trend towards decreased ED visits after referral but the trend was not statistically significant.

scholarly journals CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS: (DIS) CONTINUITY OF CARE

2021 ◽  
Vol 30 ◽  
Author(s):  
Mariane Caetano Sulino ◽  
Aline Cristiane Cavicchioli Okido ◽  
Eliane Tatsch Neves ◽  
Edmara Bazoni Soares Maia ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Children And Youth ◽  
Care Services ◽  
Healthcare Needs ◽  
Primary Health ◽  
Primary Health Care Services

ABSTRACT Objective to investigate the follow-up and characteristics of children and youth with special healthcare needs within Primary Health Care services located in a city in the State of São Paulo, Brazil. Method this qualitative study was supported by the Primary Health Care framework, and interviews were held with 37 health workers from the primary health care units located in the interior of São Paulo. Data were collected from May to December 2018 and treated with inductive thematic analysis. Results from the perspective of the health workers, the characteristics of these children and youth are centered on the dependence of specific care such as to promote psychomotor development, and dependence on technology and pharmacological treatments. They reported the difficulty to access health services while the primary health care services do not implement systematic follow-up. Conclusion these children and youth demand continuous and longitudinal care, which, however, is not provided by primary health care services, considering the discontinuity of care and a lack of networked follow-up. Therefore, health services need to be reorganized to keep up with changes in the child and youth morbidity and mortality to ensure continuous, integral, and networked follow-up to this population.

scholarly journals Assessment, Allocation, And Management Of Home And Community Care Services For Medically Complex Children : A Case Study

2021 ◽  
Author(s):  
David Salib
Keyword(s):  
Community Care ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Local Health ◽  
Health Human Resource ◽  
Care Needs ◽  
Care Services ◽  
Home And Community Care ◽  
Care Coordinators

This study examines the experiences of CCAC Care Coordinators when assessing, allocating, and managing medically complex children who require home and community care services. A case-study design was implemented, employing a focus group with seven Care Coordinators and an analysis of the 14 Local Health Integration Networks (LHINs) Integrated Health Service Plans (IHSPs) across Ontario. Three major findings arose from the study. First, families are experiencing increased levels of burden related to the child's care responsibilities. Second, there remains a health human resource shortage of individuals with a specialization in paediatrics in the home and community sector. Third, Care Coordinators function as street-level bureaucrats when allocating publicly funded services without the use of a standardized assessment tool. Ultimately, a model of care needs to be implemented supporting a balanced approach to assessment, utilizing standard assessment tools while providing a means for Care Coordinators to utilize their expertise in allocating services.

scholarly journals Who Is Doing What in Home Care Services?

2021 ◽  
Vol 18 (19) ◽  
pp. 10504
Author(s):  
Berit Irene Helgheim ◽  
Birgithe Sandbaek
Keyword(s):  
Home Care ◽  
Registered Nurses ◽  
Health Workers ◽  
Care Service ◽  
Home Care Services ◽  
Smartphone Application ◽  
Care Staff ◽  
Care Services ◽  
Patient Work ◽  
Assistant Nurses

(1) Background: This paper investigates the distribution of work hours by activity, for the main staff categories in home care services in three rural Norwegian municipalities. In Norway these categories are registered nurses, assistant nurses and assistant health workers. (2) Methods: The three categories of home care staff recorded 20,964 eligible observations over 8 weeks. We identified 19 activities, which were recorded. The majority of staff used a smartphone application for the time measuring, while some staff used a manual form for reporting purposes. (3) Results: The registered nurses (RNs) spent 32% of their time on direct patient work, while driving accounted for 18%. Direct patient work and driving accounted for the majority of activities performed by assistant nurses (48% and 29%, respectively) and assistant health workers (70% and 17%, respectively). (4) Conclusions: The demand for home care services is increasing in terms of both size and complexity. Simultaneously, there is a growing shortage of skilled staff. RNs is the group with the least face-to-face time with patients. To meet the patients’ needs, it is necessary to discuss and modify existing home care service systems in order to use resources appropriately and effectively.

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