Characteristics of Client Service Utilization and Cost, Degree of Care Implementation and Outcomes by Type of Home Care Agencies

Abstract

The purpose of this study was to identify characteristics of clients' service utilization and cost, degree of care implementation and outcomes by type of home care agencies.

Subjects were 257 clients in 7 home care agencies. We assessed changes of outcomes including IADL, ADL, and willingness during a period of two months. In addition, we studied type, frequency and cost of services, and implemented services to promote independence of the clients for two months.

As a result, the independence level was higher in the clients of visiting care stations. Their spouses were primary caregivers, and also many clients lived alone by using mainly visiting care services. The independence level was lower in the clients of visiting nursing stations. They lived with their families, and were likely to use bathing and to visit rehabilitation centers. The clients in ambulatory rehabilitation centers were regarded as care level of J, B, and their daughters in law were primary caregivers. They also used significantly more day service and short-stay. Use of wheelchair and improvement of ADL were higher in the clients of visiting nursing stations. There was a tendency that improvement of willingness was higher in the clients of ambulatory rehabilitation centers while it was maintained in those of visiting nursing stations. It can be effective to implement a broad range of care including functional training, excretion care, fall prevention and encouraging socializing to improve ADL. Recreation, functional training and psychological support in ambulatory services are necessary to improve the willingness. It is worth for the clients to pay the costs for these services to promote their independence.