プライマリケアの質 オープンアクセス

抽象的な

Does the use of care plans improve the quality of home care?

Sabine Van Houdt, Jan De Lepeleire

BackgroundTo ensure coordinated care in complex home care situations in Flanders a system of funded care plans was developed some 15 years ago. In the literature little evidence is found on the value of care plans in home care. The question arises as to whether funding and implementing these care plans has a significant effect on the quality of home care. MethodsA multicentre, non-randomised control group design was used. Care situations with a funded care plan were selected in five Flemish regions. In three control regions, similar situations were chosen. All patients, informal caregivers and healthcare professionals in the selected care situations received a postal questionnaire. Main outcome measures were SF12, the Zarit Burden Scale, satisfaction and hospitalisation. Data were calculated in proportions. Contingency tables were evaluated using the chi-square test. ResultsThere was no significant effect on hospitalisation, the perceived general health of the patient, the perceived burden on the informal caregiver or on satisfaction with the delivered care of all involved. In care situations with a care plan, goals were more often formulated and achieved. A positive correlation was found between formulating goals and adequately evaluating and adjusting care. The healthcare professionals in the intervention group had a more positive attitude towards and participated significantly more in team meetings. Conclusion Care plans in home care lead to significant differences in process, but they have no effect on outcomes for patients and informal caregivers.