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Home-care Services (home-care + services)
Selected AbstractsInquiry into the ideal function of the pharmacy in home care,GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2004Mitsuko Onda Background: The aim of this study is to analyze why home-care services provided by pharmacists have not been effectively utilized. Method: Questionnaires were submitted to home-care service users, physicians, visiting nurses and home-helpers and pharmacy directors. We studied whether gaps existed between users' needs, physicians' expectations of pharmacy services and pharmacists' awareness of the importance of pharmacy services. We also investigated whether a failure to recognize the importance of cooperation with pharmacists in home-care provision existed among physicians and nurses/home-helpers. Results: Users and physicians expect pharmacists to be more involved in counseling about home care and welfare services than home-visiting services. Pharmacists recognize home visiting services as being of greater importance than counseling about home care and welfare services. The results indicated that gaps existed between users' needs, the physicians' expectations and pharmacists' awareness of the importance of pharmacy services. In terms of cooperation with pharmacists, study results implied that: (i) nurses/home-helpers' awareness of pharmacists' home-visiting service is lower than that of physicians; (ii) physicians' expectations regarding pharmacists' participation in home care services is lower than that of nurses/home-helpers; (iii) over 70% of both groups recognize the necessity of pharmacists' home-visiting service. Conclusions: Pharmacists need to get more involved in counseling users about home care and welfare. Also, there should be a special focus on heightening nurses/home-helpers' awareness of pharmacists' home-visiting service and on raising physicians' expectations for pharmacists' participation in home care services to develop home-care related pharmacy services in Japan. [source] Creating and sustaining disadvantage: the relevance of a social exclusion frameworkHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2009Amanda M. Grenier PhD MSW BSW Abstract Over the last decade, public home-care services for elderly people have been subject to increased rationing and changes in resource allocation. We argue that a social exclusion framework can be used to explain the impacts of current policy priorities and organisational practices. In this paper, we use the framework of social exclusion to highlight the disadvantages experienced by elderly people, particularly those who cannot afford to supplement public care with private services. We illustrate our argument by drawing on examples from previous studies with persons giving and receiving care in the province of Québec. Our focus is on seven forms of exclusion: symbolic, identity, socio-political, institutional, economic, exclusion from meaningful relations, and territorial exclusion. These illustrations suggest that policy-makers, practitioners and researchers must address the various ways in which current policy priorities can create and sustain various types of exclusion of elderly people. They also highlight the need to reconsider the current decisions made regarding the allocation of services for elderly people. [source] The impact of managed competition on diversity, innovation and creativity in the delivery of home-care servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2008Glen E. Randall PhDArticle first published online: 28 JUN 200 Abstract Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of ,managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving. [source] Health-care reform and the dimensions of professional autonomyCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 1 2009Glen E. Randall With this model, it was assumed that competitive forces would encourage quality while driving down costs. While such reforms often achieve cost controls by constraining the incomes and practices of health-care workers, there has been relatively little analysis of the extent to which self-governing health-care professionals, particularly those outside of medicine and nursing, may experience a decline in their ability to control the content and context of their professional work. In this article, the authors analyse the results of thirty-six in-depth interviews with representatives of Community Care Access Centres (CCACs), the organizations that purchase and coordinate the delivery of home-care services, and rehabilitation provider agencies to examine the impact of Ontario's managed competition reform on rehabilitation professionals. Findings suggest that the impact of the reform varied across the economic, political, and clinical dimensions of professional autonomy and that, despite a general loss of autonomy under the managed competition model, market forces also served to mitigate the loss of autonomy, thus contributing to a remarkable resilience of professional autonomy. Sommaire: Un modèle de « concurrence dirigée » a été introduit récemment dans la province canadienne de l'Ontario dans le cadre de la réforme gouvernementale des soins à domicile. Avec ce modèle, il était présumé que les forces de la concurrence encourageraient la qualité tout en faisant baisser les coûts. Alors que de telles réformes parviennent souvent à maîtriser les coûts en réduisant les revenus et les pratiques des travailleurs de la santé, il y a eu relativement peu d'analyses de faites sur la mesure dans laquelle les professionnels de la santé autonomes, particulièrement ceux qui exercent en dehors de la médecine et de la profession infirmière, connaissent une perte de contrôle sur le contenu et le contexte de leur travail professionnel. Dans le présent article, les auteurs analysent les résultats de trente-six entrevues en profondeur menées auprès de représentants des Centres d'accès aux soins communautaires (CASC), organismes qui achètent et coordonnent la prestation des services de soins à domicile, et organismes de prestation de soins de réadaptation, afin d'examiner les conséquences de la réforme de la concurrence dirigée de l'Ontario sur les professionnels de la réadaptation. Les résultats laissent entendre que l'effet de la réforme a varié en fonction des dimensions économiques, politiques et cliniques de l'autonomie professionnelle et que, malgré une perte d'autonomie générale liée au modèle de concurrence dirigée, les forces du marché ont également permis d'atténuer la perte d'autonomie, contribuant ainsi à la remarquable résilience dont font preuve ces professionnels en la matiére. [source] | ||||||||||