Authors' objectives:

Most industrialized countries have initiated health care system reforms that are aiming to increase the number and scope of health services delivered on an ambulatory basis and at the patient's home. Traditional home healthcare services include case management, nursing, personal care, home support (or homemaking), occupational and physical therapies, social work counseling, nutrition counseling, and respiratory therapy. More complex forms of clinical treatments at home are emerging, such as IV therapy, life support/ventilator assistance systems, cancer therapy, palliative care, and services for persons with AIDS or Alzheimer's disease. This report is mainly concerned with these latter forms of interventions, i.e. high-tech home care.

Authors' recommendations: Current challenges in the organization and delivery of home care call for immediate policy actions. Sophisticated technology is changing the nature of health systems across industrialized countries, and one of its most significant developments is the use of complex equipment in the patient's home. The use of such equipment often requires the clinical and technical expertise of secondary and tertiary level care providers, as well as a keen understanding of home care patients needs and expertise that CLSC home care program staff have developed for particular clientele over the last two decades in Quebec. One critical challenge, for the next decade, will be to bring these two types of expertise together in order to provide specialized home care that remains meaningful for the patients and their relatives, while being effective from clinical and organizational perspectives. In this endeavour, coordination among individual care providers and among health organizations is key, as is building the technical and clinical competence of providers, patients, and caregivers. Each of our four recommendations addresses a particular facet of the home care problem. While a global vision of home care should help structure the future of this service in Quebec, regional leadership is required to support and implement organizational incentives that will enable effective coordination between hospitals and CLSCs or the 'reseaux locaux de services' in which they are now integrated.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.aetmis.gouv.qc.ca/

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Agence d'évaluation des technologies et des modes d'intervention en santé

Contact Address: 2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS)