2017 Volume 17 Issue 4 Pages 192-196
This study aims to visualize the process and problems in initiating homecare in Tenri area. First, we interviewed homecare providers to learn of the initiation process and trouble they encountered at that time. Additionally, two researchers qualitatively analyzed the results of interviews and made a conceptualization of the process and the problems. Furthermore, we made some questionnaires based on the qualitative analysis. Finally, we performed questionnaire surveys in all healthcare facilities providing homecare in Tenri area. In 12 homecare facilities (10 clinics and 2 hospitals), a total of 16 physicians provided 468 patients with homecare in 2013. Of the 468 patients, 30 % are referrals from hospitals (22% from medical doctors, 8% from care coordinators), 29% are transition from outpatients and 16% are direct contacts from patients or their families. Except for one facility specializing in homecare, the others are transition from their outpatients, referral from hospitals and direct contacts from patients and the families resulting in 36%, 21% and 20% respectively. The most frequent problem of the process is maintaining a system providing 24-hour service in each facility. In addition, shortage of family caregivers, no wish of caregivers to receive homecare, instability of patients' livelihood and busyness of each clinic are reported as issues in initiation of homecare.
It is needed for homecare doctors to understand pain, give 24-hour support and manage unpredictable requests from hospitals or patients' families. Furthermore, we should pay attention to coordination among livelihood support, long term nursing care and public welfare in the area.
