Needs assessment for hospital‐based home care services

Abstract

Careful needs assessment is a prerequisite to addressing issues of health care program effectiveness and program planning from a population-based perspective. Home care program evaluation literature is lacking in examples of strategies for such assessment. A nurse-screening of admissions was conducted at an acute care general hospital to estimate need for hospital-based home care (HBHC) services among the 2,613 patients discharged from medical and surgical services over a 5-month period. After careful delineation of inclusion and exclusion criteria for identifying HBHC patients and participant-observer training, the nurse's judgments on patient appropriateness for HBHC care were shown to agree reliably with those of the HBHC staff (k = + .45). In the study hospital under current conditions, an estimated 64% of discharged patients appropriate for home care do not receive these services. A comparison of the incidence according to service of HBHC-appropriate patients and patient-referral rates to HBHC suggests that one service over-refers (neurology), but most under-refer. Screening nurse salary expenditures constitute the major costs of this approach to home care needs assessment, which is recommended only for addressing major, infrequent programmatic policy issues.

Sistema de classificação de pacientes em assistência domiciliária

“…No levantamento bibliográfico, o estudo de Inui et al (11) , identifica a adequação das indicações da equipe de assistência domiciliária de um hospital para pacientes ao programa de AD. Conclui que a técnica de avaliação apresentada, embora confiável, demandava um custo elevado, pela exigência de juízes, enfermeiras com habilidades clínicas e com experiência relevante anterior.…”

A Checklist To Assess the Need for Home Health Care: Instrument Development and Validation

“…Our original goal in this research was to examine the impact of the Medicare prospective payment plan on a home health service in a teaching hospital; however, before such a study could be conducted, it was necessary to develop and validate an instrument for gathering data, as one could not be found in the literature that was applicable in this study. A review of the literature revealed only one paper in which psychometric research consisting of validity or reliability studies had been conducted on the instrument itself prior to its use in assessing patient need for home care (Inui, Stevenson, Plorde, & Murphy, 1980). That study and the present one differ in several respects.…”

Adaptação de instrumento para dimensionar horas diárias de assistência de enfermagem residencial

“…No levantamento bibliográfico dos últimos 20 anos, os estudos reconhecem muito mais o perfil do paciente que necessita da assistência de enfermagem domiciliar, do que a quantificação da demanda do cuidado no momento da alta hospitalar (11)(12) .…”