Abstract
The revised regulation for nursing compensation in FY2012 established the basic fee for at-home reinforcement type geriatric health services facilities, recommending a shift from nursing care in geriatric health services facilities (GHSFs) to home care. However, the number of at-home reinforcement type GHSFs to which an application of the basic fee was approved was still low. We conducted a philological study to elucidate actual efforts and present challenges in facilities where a basic fee for at-home reinforcement type care has been introduced.
We retrieved relevant reports published since 2012 through a web search of databases such as the web version of the Japan Medical Abstract Society. Four key words were used: geriatric health services facilities, at-home reinforcement type, return home, and at-home care support. A total of 32 relevant reports were extracted.
Efforts underway to improve the rate of returning home in such facilities include 1) confirming the aim of entering the facility before and at the time of admission, 2) giving importance to rehabilitation, and 3) supporting the user's family to change their mind about the possibility of nursing care at home. Current challenges include a decrease in the bed occupancy rate and an increase in staff burden due to the increase in the number of persons admitted or discharged.
To improve the rate of returning home for such facilities, each user should set up, with staff and family members, a concrete objective of returning home. In addition, multidisciplinary collaboration is important to achieve this objective.
