Elderly people in rural areas receive fewer home health care services and have worse outcomes than those in urban areas

2002 ◽  
Keyword(s):  
Health Care ◽  
Elderly People ◽  
Home Health Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Care Services ◽  
Home Health ◽  
Care Services

scholarly journals From village health volunteers to paid care givers: the optimal mix for a multidisciplinary home health care workforce in rural Thailand

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Nonglak Pagaiya ◽  
Thinakorn Noree ◽  
Penapa Hongthong ◽  
Karnwarin Gongkulawat ◽  
Pagaluk Padungson ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Workforce ◽  
Rural Areas ◽  
Health Care Services ◽  
Home Visits ◽  
Home Health ◽  
Care Services ◽  
Care Givers ◽  
Rural Thailand

Abstract Background Thailand is a rapidly aging society, which places high demand on home health care services for the elderly. The shortage of health care workforce in rural areas is a crucial obstacle to the delivery of adequate home health care services. The appropriate skill-mix between multidisciplinary health team and care givers (CGs) is an attractive solution for improving home health care services in rural Thailand. This study assessed the potential of trained CGs to provide home health care services and projected what the optimal mix for a multidisciplinary home health care team in rural Thailand would be in 2030. Methods Eleven pilot districts in Thailand were recruited for the study. Secondary data were collected along with surveys of home health care providers. A total of 130 care managers (nurses) and 351 care givers (CG) were recruited for the survey. Workload, skill-mix potential, and acceptance of care givers were assessed in the surveys. The results from secondary data and the survey were used to project the health workforce requirements in 2030. Results It is projected that in 2030 the number of elderly living in rural areas will be 7,156,700 (27% of the projected rural population). Of this, 20.3% will be home-bound, 1.1% will be bed-ridden and 1.6% will need rehabilitation. The main members of the multidisciplinary health workforce involved in home health care were nurses, doctors, and physiotherapists. The home health care services that were provided by the multidisciplinary health workforce included patient assessment, development of a care plan and case conference, home visits, and teaching and supervision of CGs. The CGs were village health volunteers trained to carry out regular home visits to patients. The CGs provided assistance with the activities of daily living, basic health services, moral support to patients and relatives, and surveillance of the home environment during home visits. CGs were well accepted by both the health professionals and the patients. Projections showed that 16,094 nurses, 1,542 doctors, 1,022 physiotherapists and 50,148 CGs will be required in 2030 to meet the needs of the dependent elderly for home health care in rural Thailand. Conclusion With the increased need for home health care services in the future, appropriate team work between the members of the multidisciplinary health team and the CGs in the community is the appropriate solution for likely shortages of health professional workforce.

scholarly journals Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity

2021 ◽  
Vol 18 (11) ◽  
pp. 5623
Author(s):  
Jamie M. Smith ◽  
Haiqun Lin ◽  
Charlotte Thomas-Hawkins ◽  
Jennifer Tsui ◽  
Olga F. Jarrín
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Race And Ethnicity ◽  
Health Care Services ◽  
Propensity Scores ◽  
The United States ◽  
Home Health ◽  
Medicare Beneficiaries ◽  
Timely Initiation ◽  
Care Services

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical and geographic variables, and neighborhood socioeconomic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to the patients who received home health care within the recommended first two days, the patients who received delayed services (3–7 days after discharge) had higher odds of rehospitalization (OR, 1.28; 95% CI, 1.25–1.32). Among the patients who received late services (8–14 days after discharge), the odds of rehospitalization were four times greater than among the patients receiving services within two days (OR, 4.12; 95% CI, 3.97–4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

Home Health Care Services for AIDS Patients: One Community's Response

1993 ◽  
Vol 10 (1) ◽  
pp. 39-51 ◽  
Author(s):  
Pamela J. Salsberry ◽  
Jennie T. Nickel ◽  
Muriel O'Connell ◽  
Nancy R. Reynolds ◽  
Diana L. Brady ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Aids Patients ◽  
Care Services

scholarly journals Recent planning approaches and mobility concepts for home health care services in Austria – A review

2018 ◽  
Vol 68 (4) ◽  
pp. 205-222
Author(s):  
Patrick Hirsch
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Home Health ◽  
Future Research ◽  
Comprehensive Overview ◽  
Family Structures ◽  
Routing And Scheduling ◽  
Sustainable Solutions

Summary Home health care (HHC) services are faced with a rising demand in Austria. This is due to an increased life expectancy, changing family structures, and the trend to grow old at home. The percentage of their working time that is spent by the HHC staff for travelling from one client to the next one reaches 30% and even more in some rural areas. Changing the assignment of HHC staff to clients and the sequence of visits can lead to major reductions in the travel distances, and therefore, to more sustainable solutions. The aim of this paper is to provide a comprehensive overview on the logistical planning of HHC services in Austria. In order to meet the future requirements, it is important to analyze different mobility concepts for the HHC staff and to provide tailored solution approaches for routing and scheduling. The reader learns about the current HHC situation in Austria, the logistical requirements for planning these services, possible mobility concepts for the HHC staff, and potential threats for HHC operations. The developed solution methods are presented in brief and the main findings are highlighted and discussed. The paper concludes with an outlook on potential future research paths in HHC routing and scheduling.

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