scholarly journals Funding Influencing Practice and Outcomes in Reablement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 419-419
Author(s):  
Paul Rouse ◽  
Matthew Parsons

Abstract Internationally, Home Care is invariably funded through fee-per-service, e.g., if an hour of care is delivered, the provider receives an associated amount of funding. However, the funding model discourages reductions in packages-of-care when a client’s functional capacity improves, and further disincentivises providers to discharge clients. Similarly, staff income is often directly associated to the delivered hours-of-care and if a client’s hours are reduced, so is their income; again, discouraging the right behaviour, such as reporting improvements in independence levels. In 2008 in New Zealand, we developed a case-mix funding methodology and have been progressively implementing the new model since that time. This presentation highlights the findings in relation to how Home Care service hour allocations titrate against needs following implementation of the model as well as a number of other key quality outcomes that have been observed as a result of the case-mix model.

2021 ◽  
pp. 135050682110427
Author(s):  
Lena Grip ◽  
Ulrika Jansson

Society needs to find new ways to utilise its resources in the best possible way in order to enable satisfactory services for its citizens in the long term. This is particularly important in sparsely populated areas, and in cities and municipalities with a declining population. This study contributes to this field by analysing a project for collaboration between the rescue service and the home-care service that has been introduced in a number of Swedish municipalities. The collaboration is intended to ensure welfare and safety for citizens, to guarantee a more efficient use of municipal resources, and to contribute to improved emergency management and civil protection. The rescue service and the home-care service are two clearly gender-coded occupations that also operate on gender-coded work places and places of work. An overarching aim has therefore been to study gendered obstacles and possibilities of the collaboration. In our analysis of the empirical data – interviews with persons involved in the collaboration – place emerged as an important aspect of the collaboration processes, and is therefore elaborated in this article to contribute with knowledge of how conceptions and gender-coding of places and occupations affect sustainable and well-functioning collaboration processes. The results show that collaboration processes between municipal services are complex and challenge ideals of the organisation, content and responsibility of work and who should perform certain work tasks. Notions of gender and gender differences are reproduced through the collaboration, which affect the efforts of municipalities to ensure welfare and safety for citizens.


1950 ◽  
Vol 50 (2) ◽  
pp. 49
Author(s):  
Inc. Pathescope Company of America

2021 ◽  
pp. 108482232199477
Author(s):  
Tracy Chippendale ◽  
Patricia Gentile

Most people prefer to age in place. However, there is a growing body of literature to suggest a reluctance to accept supportive services in the home due to concerns about trust, privacy, cost, and fear of being a burden. The purpose of this study was to examine potential facilitators and barriers to accepting home care services in the website content of Licensed Home Care Service Agencies (LHSCA). In this linguistic analysis study, the written content from 88 randomly selected LHCSA websites was examined. We used LIWC2015 and Microsoft® Word software to analyze websites for relevant word categories that reflect older adult identified facilitators and barriers to the acceptance of home care services. Results revealed that the summary score for clout (i.e., confidence and leadership reflected in the writing) was high. Some of the most commonly used word categories were positive emotions, present focused, and affiliation. The word category money was included, but to a lesser degree. However, Burden and related words were highly prevalent in the writing sample. In summary, LHCSA website content contains both facilitators and barriers to the acceptance of home care services. Given the importance of home care services in promoting the ability of older adults to age in place, greater attention may be needed regarding the way services are presented and advertised to consumers.


2013 ◽  
Vol 25 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Haluk Mergen ◽  
Ilhami Unluoglu ◽  
Omur Elcioglu

2019 ◽  
Author(s):  
Linn Nathalie Støme ◽  
Tron Moger ◽  
Kristian Kidholm ◽  
Kari J Kværner

BACKGROUND Home care service in Norway is struggling to meet the increasing demand for health care under restricted budget constraints, although one-fourth of municipal budgets are dedicated to health services. The integration of Web-based technology in at-home care is expected to enhance communication and patient involvement, increase efficiency and reduce cost. DigiHelse is a Web-based platform designed to reinforce home care service in Norway and is currently undergoing a development process to meet the predefined needs of the country’s municipalities. Some of the main features of the platform are digital messages between residents and the home care service, highlighting information on planned and completed visits, the opportunity to cancel visits, and notifications for completed visits. OBJECTIVE This study aimed to test the usability and economic feasibility of adopting DigiHelse in four districts in Oslo by applying registry and behavioral data collected throughout a one-year pilot study. Early health technology assessment was used to estimate the potential future value of DigiHelse, including the predictive value of behavior data. METHODS Outcome measures identified by stakeholder insights and scenario drafting in the project’s concept phase were used to assess potential socioeconomic benefits. Aggregated data were collected to assess changes in health consumption at baseline, and then 15 and 52 weeks after DigiHelse was implemented. The present value calculation was updated with data from four intervention groups and one control group. A quasi-experimental difference-in-difference design was applied to estimate the causal effect. Descriptive behavioral data from the digital platform was applied to assess the usability of the platform. RESULTS Over the total study period (52 weeks), rates increased for all outcome estimates: the number of visits (rate ratio=1.04; <italic>P</italic>=.10), unnecessary trips (rate ratio=1.37; <italic>P</italic>=.26), and phone calls (rate ratio=1.24; <italic>P</italic>=.08). A significant gap was found between the estimated value of DigiHelse in the concept phase and after the one-year pilot. In the present pilot assessment, costs are expected to exceed potential savings by €67 million (US $75 million) over ten years, as compared to the corresponding concept estimates of a potential gain of €172.6 million (US $193.6 million). Interestingly, behavioral data from the digital platform revealed that only 3.55% (121/3405) of recipients actively used the platform after one year. CONCLUSIONS Behavioral data provides a valuable source for assessing usability. In this pilot study, the low adoption rate may, at least in part, explain the inability of DigiHelse to perform as expected. This study points to an early assessment of behavioral data as an opportunity to identify inefficiencies and direct digital development. For DigiHelse, insight into why the recipients in Oslo have not made greater use of the Web-based platform seems to be the next step in ensuring the right improvement measures for the home care service.


10.2196/14780 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e14780
Author(s):  
Linn Nathalie Støme ◽  
Tron Moger ◽  
Kristian Kidholm ◽  
Kari J Kværner

Background Home care service in Norway is struggling to meet the increasing demand for health care under restricted budget constraints, although one-fourth of municipal budgets are dedicated to health services. The integration of Web-based technology in at-home care is expected to enhance communication and patient involvement, increase efficiency and reduce cost. DigiHelse is a Web-based platform designed to reinforce home care service in Norway and is currently undergoing a development process to meet the predefined needs of the country’s municipalities. Some of the main features of the platform are digital messages between residents and the home care service, highlighting information on planned and completed visits, the opportunity to cancel visits, and notifications for completed visits. Objective This study aimed to test the usability and economic feasibility of adopting DigiHelse in four districts in Oslo by applying registry and behavioral data collected throughout a one-year pilot study. Early health technology assessment was used to estimate the potential future value of DigiHelse, including the predictive value of behavior data. Methods Outcome measures identified by stakeholder insights and scenario drafting in the project’s concept phase were used to assess potential socioeconomic benefits. Aggregated data were collected to assess changes in health consumption at baseline, and then 15 and 52 weeks after DigiHelse was implemented. The present value calculation was updated with data from four intervention groups and one control group. A quasi-experimental difference-in-difference design was applied to estimate the causal effect. Descriptive behavioral data from the digital platform was applied to assess the usability of the platform. Results Over the total study period (52 weeks), rates increased for all outcome estimates: the number of visits (rate ratio=1.04; P=.10), unnecessary trips (rate ratio=1.37; P=.26), and phone calls (rate ratio=1.24; P=.08). A significant gap was found between the estimated value of DigiHelse in the concept phase and after the one-year pilot. In the present pilot assessment, costs are expected to exceed potential savings by €67 million (US $75 million) over ten years, as compared to the corresponding concept estimates of a potential gain of €172.6 million (US $193.6 million). Interestingly, behavioral data from the digital platform revealed that only 3.55% (121/3405) of recipients actively used the platform after one year. Conclusions Behavioral data provides a valuable source for assessing usability. In this pilot study, the low adoption rate may, at least in part, explain the inability of DigiHelse to perform as expected. This study points to an early assessment of behavioral data as an opportunity to identify inefficiencies and direct digital development. For DigiHelse, insight into why the recipients in Oslo have not made greater use of the Web-based platform seems to be the next step in ensuring the right improvement measures for the home care service.


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