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What is important to continuity in home care?: Perspectives of key stakeholders

Author

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  • Woodward, Christel A.
  • Abelson, Julia
  • Tedford, Sara
  • Hutchison, Brian

Abstract

In Canada, home care is growing rapidly. Each province takes a somewhat different approach to its delivery. Ontario uses a competitive bidding model to award contracts to community agencies that bid for service delivery rights. Contracts are to be awarded based on quality and price. However, the attributes thought to contribute to high quality, such as continuity of care, are not clearly defined and are not measured. We sought to identify factors that were important to experiencing continuity of care in home care. We interviewed home care clients and their caregivers, workers in the home care system (nursing and homemaking service providers, case managers) and physicians whose patients use home care. During in-depth interviews with these key stakeholders, they described the conditions that led to continuity of care in home care. Service providers and case managers were also asked about the types of clients who need a high level of care continuity. Care that is experienced as running smoothly, that responds to clients' needs and requires no special effort for clients to maintain, was seen as having continuity. The attributes of care experienced as facilitating continuity could be grouped under two dimensions of care--managing care (care planning, monitoring and review; and care coordination) and direct service provision (uninterrupted service delivery; consistent, appropriate knowledge and skills; ongoing accurate observation; trusting relationship between service provider and client/caregiver; rapport among team members; and consistent timing). Different stakeholders emphasized different attributes of care as most important to continuity. Clients included consistency of timing of service delivery while rarely mentioning care management issues. They emphasized the importance of consistent knowledge and skills in the workers and trusting relationships as important to experiencing care continuity. The description of attributes of continuity of home care that emerged from this study is compared to definitions found in the nursing, mental health and primary care literature.

Suggested Citation

  • Woodward, Christel A. & Abelson, Julia & Tedford, Sara & Hutchison, Brian, 2004. "What is important to continuity in home care?: Perspectives of key stakeholders," Social Science & Medicine, Elsevier, vol. 58(1), pages 177-192, January.
  • Handle: RePEc:eee:socmed:v:58:y:2004:i:1:p:177-192
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    Citations

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    Cited by:

    1. Finlay, Susanna & Sandall, Jane, 2009. ""Someone's rooting for you": Continuity, advocacy and street-level bureaucracy in UK maternal healthcare," Social Science & Medicine, Elsevier, vol. 69(8), pages 1228-1235, October.
    2. Zeytinoglu, Isik U. & Denton, Margaret & Brookman, Catherine & Plenderleith, Jennifer, 2014. "Task shifting policy in Ontario, Canada: Does it help personal support workers’ intention to stay?," Health Policy, Elsevier, vol. 117(2), pages 179-186.
    3. Margaret Denton & Isik Zeytinoglu & Karen Kusch & Sharon Davies, 2007. "Market-Modelled Home Care: Impact on Job Satisfaction and Propensity to Leave," Canadian Public Policy, University of Toronto Press, vol. 33(s1), pages 81-99, January.
    4. David, Guy & Kim, Kunhee Lucy, 2018. "The effect of workforce assignment on performance: Evidence from home health care," Journal of Health Economics, Elsevier, vol. 59(C), pages 26-45.
    5. Yang, Meng & Ni, Yaodong & Song, Qinyu, 2022. "Optimizing driver consistency in the vehicle routing problem under uncertain environment," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 164(C).
    6. Abelson, Julia & Gold, Sara Tedford & Woodward, Christel & O'Connor, Denise & Hutchison, Brian, 2004. "Managing under managed community care: the experiences of clients, providers and managers in Ontario's competitive home care sector," Health Policy, Elsevier, vol. 68(3), pages 359-372, June.
    7. Anirudh Subramanyam & Chrysanthos E. Gounaris, 2018. "A Decomposition Algorithm for the Consistent Traveling Salesman Problem with Vehicle Idling," Transportation Science, INFORMS, vol. 52(2), pages 386-401, March.
    8. Attila A. Kovacs & Bruce L. Golden & Richard F. Hartl & Sophie N. Parragh, 2015. "The Generalized Consistent Vehicle Routing Problem," Transportation Science, INFORMS, vol. 49(4), pages 796-816, November.
    9. Koyuncu, Işıl & Yavuz, Mesut, 2019. "Duplicating nodes or arcs in green vehicle routing: A computational comparison of two formulations," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 122(C), pages 605-623.
    10. Raffaele Argiento & Alessandra Guglielmi & Ettore Lanzarone & Inad Nawajah, 2016. "A Bayesian framework for describing and predicting the stochastic demand of home care patients," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 254-279, June.
    11. Ali Kazemi & Petri J. Kajonius, 2021. "Understanding client satisfaction in elderly care: new insights from social resource theory," European Journal of Ageing, Springer, vol. 18(3), pages 417-425, September.

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