Home care and the reshaping of acute hospitals in England – An overview of problems and possibilities

Abstract

A changing boundary between hospital and home-care services over two decades has taken place enabling people to live in their own homes wherever possible, enabling "choice of independence". Against this background, five principal issues are raised regarding how hospital services have been reshaped over that time and how the pattern of service developments outside the hospital has altered over the same period.

Internal and external environmental factors affecting the performance of hospital‐based home nursing care

“…Correlation with the ratio of outpatients to inpatients was also over 0.5, showing a very significant positive correlation, indicating that hospitals experiencing more pressure on hospitalization with relatively more outpatients than inpatients led to more products of HNC. This result was similar to Wistow's (2000), who showed increasing pressure on hospitalization promoted discharge of patients and increased usage of HNC.…”

Human and organisational aspects of remote patient monitoring in residential care homes

“…Consequently, as a result of cost-issues, over-crowded hospitals and the preference of elderly people to remain in their normal environment, there has been a trend to move away from hospital-based healthcare to home-based healthcare (Maheu et al, 2001). The UK government has also been actively promoting home-based healthcare as part of its programme to move services into the community (Wistow, 2000). It is speculated that with the provision of home care services, patients can live in their usual environment for longer, thus avoiding the hotel costs of hospital; the patients' own care-givers can provide no-cost nursing; and the actual costs of primary care are often lower than the equivalent service provided from hospital (Hersh et al, 2002).…”