What Is Home Healthcare? Scope, Advantages and Disadvantages

Home healthcare can briefly be described as healthcare bringing patients and professionals together in the home. Its aims are to provide support enabling bedridden patients, those with limited mobility and those with serious illnesses to continue treatment at home. It also aims to improve older people’s quality of life by enabling independent living in their own homes or surroundings. Healthcare systems supporting home care are developing every day.

History of Home Healthcare and Its Expansion in Our Country

Home healthcare services were first implemented systematically in the United States in 1965 and began expanding, followed by other countries. The first regulation establishing their place in the Turkish healthcare system was published in 2005, aiming to organize services previously provided mainly by the private sector. A directive on home healthcare provision by Ministry of Health institutions entered into force in 2010, and ministry work in this area increases daily. Under the directive updated in 2016, home healthcare is provided by units established within ministry-affiliated training and research hospitals, public or specialty hospitals and oral and dental health centers. Services are delivered through these units together with community health centers, family health centers and family physicians.

According to the relevant directive, the scope of home healthcare is described as follows:

The home healthcare unit’s role is not to diagnose illness but, based on a previous diagnosis and treatment plan established by the relevant specialist physicians , to provide examination, investigations, laboratory tests, treatment, medical healthcare and rehabilitation in the patient’s home; prescribe medicines documented by a medical report as requiring long-term use, subject to special prescribing rules; assist with reports on medical device and material use; inform patients and families about responsibilities they may assume during home care and about illness and health processes; and provide education and counseling on correct use, under appropriate conditions, of medical devices and equipment required at home for the illness.

For example, services within this scope include supporting relatives of patients fed medical nutrition through a stomach tube, collecting samples at home for necessary blood and urine tests, or administering intravenous fluid treatments suitable for the home.

The unit is also responsible for transporting referred patients to the healthcare institution and back home. Regional home care units have patient transport vehicles for this purpose. Transport costs are not charged to patients. Emergency patient transport is the responsibility of 112 emergency healthcare services.

Besides doctors, nurses and health officers, the home healthcare unit may include psychologists, physiotherapists, dietitians, social workers and spiritual care specialists.

How and When Can You Receive Home Healthcare?

Private organizations, the Ministry of Health and municipalities can provide home healthcare.

To receive Ministry of Health home healthcare, call 4443833 to register the patient in the system. A family physician and supporting healthcare staff then visit the home for initial assessment and to create a care plan.

Provincial or district municipalities may also provide home healthcare. Their general contact numbers can be used to request these services.

What Are the Advantages of Home Healthcare?

• The person needing home healthcare has more freedom and control.
• Family and familiar surroundings help the patient experience a more comfortable process.
• Patients’ own rules are respected.
• While infection risk is higher in hospital, it is lower with home healthcare.
• Home healthcare has a positive effect on quality of life .
• Home healthcare is convenient for people unable to attend hospital.

What Are the Disadvantages of Home Healthcare?

• Home healthcare requires a detailed education program and close supervision.
• Effective, positive communication may not always be established between staff, patients and families.
• Daily care activities such as dressing, cooking, bathing, cleaning the home, laundry and administering medicines may be difficult for family members, placing greater pressure on them.
• Healthcare professionals’ inability to remain continuously in the patient’s home is a limitation.

Most recipients of home healthcare include:

• People needing postoperative care,
• Orthopedic and trauma patients,
• Patients with heart, vascular disease or hypertension,
• Patients with hemiplegia (paralysis),
• Oncology (cancer) patients,
• Patients with lung and respiratory diseases,
• Patients with diabetes,
• Neurology patients,
• Other patients requiring oxygen treatment,
• New mothers and their babies,
• Older people and people with disabilities requiring healthcare,
• People needing wound care, injections, infusions and other short-term nursing services,
• People requiring laboratory investigations and testing,
• People requiring any type of medical equipment at home.

How Is Home Care Financed?

Patients pay for home healthcare received from private institutions. SGK covers services provided through Ministry of Health units as outpatient treatment. Expenses within home healthcare (intravenous fluids, medicines, injections, syringes, dressings, dressing materials and so on) are paid by SGK. To avoid paying for examinations, treatment and materials used at home (such as intravenous fluids, syringes and gauze), patients must obtain services from hospital-affiliated units.

Conclusion

Home healthcare can provide treatment while protecting the physical and mental health of families and communities. This form of palliative careis considered among the most appropriate ways to improve quality of life. It provides better public health outcomes and reduces healthcare spending. Bringing individualized healthcare into the home is rapidly becoming part of healthcare systems in developing and developed countries.