Governance on home care in Europe

Document type: Conference Presentations
Peer reviewed: Yes
Author(s): N Genet, W Boerma, A Hutchinson, A., V Garms-Homolova, M Naiditch, G Lamura, S Chablicz, K Ersek, L Gulacsi
Title: Governance on home care in Europe
Series: Journal of Clinical Nursing
Conference name: 4th European nursing congress
Year: 2010
Volume: 19
Issue: suppl. 1
ISSN: 0962-1067
Publisher: Wiley-Blackwell
Organization: Blekinge Institute of Technology
Department: School of Health Science (Sektionen för hälsa)
School of Health Science S-371 79 Karlskrona
+46 455 38 50 00
Authors e-mail:
Language: English
Abstract: Demand for health and social care services in the community will grow as a result of the ageing of populations across Europe. At present, however, very little is known about the preparedness of national home care systems for changing demand, which is not just quantitative but also qualitative in kind. There is a need for insight into the state of home care, including policy and regulation and aspects of financing, organisation and provision of services.
Methods & materials
On the basis of results of a literature review and from consultations with experts across Europe, the EURHOMAP study has developed an extensive set of indicators to map home care systems. The indicators focus on: policy and regulation; financing; organisation & service delivery; and clients & informal carers. EURHOMAP partners collected the data in 2009 and early 2010, in collaboration with experts in 31 European countries. Results were described in uniformly structured country reports and fed back to national experts for validation. An additional source of information was the answers on questions related to four ‘vignettes’ (hypothetical case descriptions of home living people in need of care). These questions were answered by a panel of key informants in each country.
The presentation will address the following topics: the availability of a policy vision on home care in the countries; how clients can access home care; how the quality of home care is maintained; which governmental levels are responsible for various aspects of home care; public versus private models of provision, including competition; the way care is monitored. It turns out that home care systems widely
Symposium Abstracts 4th Eur Nursing Congress, 4-7 Oct 2010
vary in their degree of development and that the structures of governance, regulation and models of provision are very heterogeneous. An aspect of home care that creates challenges at all levels is the mix of social, nursing and health services, which are supposed to be delivered in an integrated way to clients and patients. Cost control in community care is a common issue of most countries, but budgetary and efficiency measures taken and mechanisms developed are very different. Maintaining and improving home care services is a priority in many countries which does not always match with needs to increase efficiency. In different ways countries try to accommodate these contrasting aims.
Although home care is a major point of policy in many countries, it is not heavily regulated. In many countries home care governance is split between different types of care and, consequently, not well integrated. Despite the dominance of public provision, tendencies towards more privatisation, contracting and competition can be identified.
Subject: Nursing & Caring Sciences\General
Economics\Macro Economics
Note: Conference held in Rotterdam Authors + 10> B Bolibar