TY - JOUR
T1 - Which client characteristics predict home-care needs? Results of a survey study among Dutch home-care nurses
AU - van den Bulck, Anne O. E.
AU - Metzelthin, Silke F.
AU - Elissen, Arianne M. J.
AU - Stadlander, Marianne C.
AU - Stam, Jaap E.
AU - Wallinga, Gia
AU - Ruwaard, Dirk
N1 - Funding Information:
The study was supported by research grants from the Dutch Healthcare Authority (NZa) and from home‐care organisation MeanderGroep Zuid‐Limburg, the Netherlands. The funding bodies did not play a role in the study design, the writing of the manuscript, or the decision to submit the manuscript for publication. The views expressed are those of the authors and not necessarily those of the Dutch Healthcare Authority (NZa) or MeanderGroep Zuid‐ Limburg, the Netherlands.
Funding Information:
Funding information The study was supported by research grants from the Dutch Healthcare Authority (NZa) and from home-care organisation MeanderGroep Zuid-Limburg, the Netherlands. The funding bodies did not play a role in the study design, the writing of the manuscript, or the decision to submit the manuscript for publication. The views expressed are those of the authors and not necessarily those of the Dutch Healthcare Authority (NZa) or MeanderGroep Zuid-Limburg, the Netherlands. The authors would like to thank all nurses to take part on the survey, and all parties involved during the development and distribution of the survey: Utrecht University and University of Applied Sciences, Tilburg University, the Dutch Society of Community Nurses (NWG) and the Dutch Patient Federation.
Publisher Copyright:
© 2018 The Authors Health and Social Care in the Community Published by John Wiley & Sons Ltd
PY - 2019/1
Y1 - 2019/1
N2 - Fee-for-service, funding care on an hourly rate basis, creates an incentive for home-care providers to deliver high amounts of care. Under casemix funding, in contrast, clients are allocated-based on their characteristics-to homogenous, hierarchical groups, which are subsequently funded to promote more effective and efficient care. The first step in developing a casemix model is to understand which client characteristics are potential predictors of home-care needs. Nurses working in home care (i.e. home-care nurses) have a good insight into clients' home-care needs. This study was conducted in co-operation with the Dutch Nurses' Association and the Dutch Healthcare Authority. Based on international literature, 35 client characteristics were identified as potential predictors of home-care needs. In an online survey (May, 2017), Dutch home-care nurses were asked to score these characteristics on relevance, using a 9-point Likert scale. They were subsequently asked to identify the top five client characteristics. Data were analysed using descriptive statistics. The survey was completed by 1,007 home-care nurses. Consensus on relevance was achieved for 15 client characteristics, with "terminal phase" being scored most relevant, and "sex" being scored as the least relevant. Relevance of the remaining 20 characteristics was uncertain. Additionally, based on the ranking, "ADL functioning" was ranked as most relevant. According to home-care nurses, both biomedical and psychosocial client characteristics need to be taken into account when predicting home-care needs. Collaboration between clinical practice, policy development, and science is necessary to realise a funding model, to work towards the Triple Aim (improved health, better care experience, and lower costs).
AB - Fee-for-service, funding care on an hourly rate basis, creates an incentive for home-care providers to deliver high amounts of care. Under casemix funding, in contrast, clients are allocated-based on their characteristics-to homogenous, hierarchical groups, which are subsequently funded to promote more effective and efficient care. The first step in developing a casemix model is to understand which client characteristics are potential predictors of home-care needs. Nurses working in home care (i.e. home-care nurses) have a good insight into clients' home-care needs. This study was conducted in co-operation with the Dutch Nurses' Association and the Dutch Healthcare Authority. Based on international literature, 35 client characteristics were identified as potential predictors of home-care needs. In an online survey (May, 2017), Dutch home-care nurses were asked to score these characteristics on relevance, using a 9-point Likert scale. They were subsequently asked to identify the top five client characteristics. Data were analysed using descriptive statistics. The survey was completed by 1,007 home-care nurses. Consensus on relevance was achieved for 15 client characteristics, with "terminal phase" being scored most relevant, and "sex" being scored as the least relevant. Relevance of the remaining 20 characteristics was uncertain. Additionally, based on the ranking, "ADL functioning" was ranked as most relevant. According to home-care nurses, both biomedical and psychosocial client characteristics need to be taken into account when predicting home-care needs. Collaboration between clinical practice, policy development, and science is necessary to realise a funding model, to work towards the Triple Aim (improved health, better care experience, and lower costs).
KW - casemix
KW - client characteristics
KW - clients' needs
KW - funding
KW - home care
KW - nurse perspective
KW - OLDER-ADULTS
KW - TRIPLE AIM
KW - HEALTH
KW - RATHER
KW - SYSTEM
KW - MODEL
U2 - 10.1111/hsc.12611
DO - 10.1111/hsc.12611
M3 - Article
SN - 0966-0410
VL - 27
SP - 93
EP - 104
JO - Health & Social Care in the Community
JF - Health & Social Care in the Community
IS - 1
ER -