The Relationship Between Agency Characteristics and Quality of Home Care

Dalby, Dawn M.; Hirdes, John P.

doi:10.1300/j027v27n01_04

Cited by 15 publications

(17 citation statements)

References 13 publications

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“…Our findings suggest that the same applies to informal caregivers: in Agency A the high level of task differentiation resulted in a "succession of strangers" (Aronson, 2004) and decreased the chance of formal and informal caregivers meeting each other. In contrast, formal caregivers from Agency B had a lower caseload, which made them more accessible to informal caregivers who could contact them (Black & Fauske, 2007;Dalby & Hirdes, 2008).…”

Section: Discussionmentioning

confidence: 99%

Impact of Home Care Management on the Involvement of Informal Caregivers by Formal Caregivers

Wieringen¹,

Groenou²,

Groenewegen³

2015

Home Health Care Services Quarterly

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This study explores the link between management characteristics of home care agencies and the involvement of informal caregivers in caregiving. Based on a study of policy documents of two agencies and semi-structured interviews with five team managers and 31 formal caregivers, we conclude that, although the importance of involving informal caregivers is emphasized in official documentation, actual contact with informal caregivers is often lacking. Comparison of the work processes of the two agencies shows that contact with informal caregivers and their potential involvement are enhanced by smaller teams, less task division, and clarity about the responsibilities of formal caregivers.

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Section: Discussionmentioning

confidence: 99%

Impact of Home Care Management on the Involvement of Informal Caregivers by Formal Caregivers

Wieringen¹,

Groenou²,

Groenewegen³

2015

Home Health Care Services Quarterly

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“…For example, for the prevalence of weight loss indicator, two risk adjusters have been suggested, namely, more severe ADL impairment and a diagnosis of cancer. To date, very few studies have been completed to examine the influence of risk adjustment [8] or to explore how these indicators vary with characteristics of the provider organizations [15]. …”

Section: Introductionmentioning

confidence: 99%

A comparison of home care quality indicator rates in two Canadian provinces

Mofina

Guthrie

2014

BMC Health Serv Res

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BackgroundHome care is becoming an increasingly vital sector in the health care system yet very little is known about the characteristics of home care clients and the quality of care provided in Canada. We describe these clients and evaluate home care quality indicator rates in two regions.MethodsA cross-sectional analysis of assessments completed for older (age 65+) home care clients in both Ontario (n = 102,504) and the Winnipeg Regional Health Authority (n = 9,250) of Manitoba, using the Resident Assessment Instrument for Home Care (RAI-HC). This assessment has been mandated for use in these two regions and the indicators are generated directly from items within the assessment. The indicators are expressed as rates of negative outcomes (e.g., falls, dehydration). Client-level risk adjustment of the indicator rates was used to enable fair comparisons between the regions.ResultsClients had a mean age of 83.2 years, the majority were female (68.6%) and the regions were very similar on these demographic characteristics. Nearly all clients (92.4%) required full assistance with instrumental activities of daily living (IADLs), approximately 35% had activities of daily living (ADL) impairments, and nearly 50% had some degree of cognitive impairment, which was higher among clients in Ontario (48.8% vs. 37.0%). The highest quality indicator rates were related to clients who had ADL/rehabilitation potential but were not receiving therapy (range: 66.8%-91.6%) and the rate of cognitive decline (65.4%-76.3%). Ontario clients had higher unadjusted rates across 18 of the 22 indicators and the unadjusted differences between the two provinces ranged from 0.6% to 28.4%. For 13 of the 19 indicators that have risk adjustment, after applying the risk adjustment methodology, the difference between the adjusted rates in the two regions was reduced.ConclusionsHome care clients in these two regions are experiencing a significant level of functional and cognitive impairment, health instability and daily pain. The quality indicators provide some important insight into variations between the two regions and can serve as an important decision-support tool for flagging potential quality issues and isolating areas for improvement.

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“…Furthermore, limited resources to implement and sustain a home care infrastructure [16] and a shift of chronic care to community settings without the corresponding transfer of funds [17] compound the difficulties encountered. Although provincial government-funded home care agencies in Canada are mandated to assess and coordinate the health care needs of community-dwelling older adults with dementia, there is evidence that increasing caseloads among direct care providers [13] and case managers [18] have negatively impacted the quality of home care. …”

Section: Introductionmentioning

confidence: 99%

Dementia Home Care Resources: How Are We Managing?

Ward‐Griffin

Hall²,

DeForge³

et al. 2012

Journal of Aging Research

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With the number of people living with dementia expected to more than double within the next 25 years, the demand for dementia home care services will increase. In this critical ethnographic study, we drew upon interview and participant data with persons with dementia, family caregivers, in-home providers, and case managers in nine dementia care networks to examine the management of dementia home care resources. Three interrelated, dialectical themes were identified: (1) finite formal care-inexhaustible familial care, (2) accessible resources rhetoric-Iinaccessible resources reality, and (3) diminishing care resources-increasing care needs. The development of policies and practices that provide available, accessible, and appropriate resources, ensuring equitable, not necessarily equal, distribution of dementia care resources is required if we are to meet the goal of aging in place now and in the future.

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The Relationship Between Agency Characteristics and Quality of Home Care

Cited by 15 publications

References 13 publications

Impact of Home Care Management on the Involvement of Informal Caregivers by Formal Caregivers

Impact of Home Care Management on the Involvement of Informal Caregivers by Formal Caregivers

A comparison of home care quality indicator rates in two Canadian provinces

Dementia Home Care Resources: How Are We Managing?

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