Paediatric home care in Tower Hamlets: a working partnership with parents.
OBJECTIVE
To describe the first two years of a paediatric home care service.


METHODS
Observational cross sectional study, 1989-91.


METHODS
One inner London health district.


METHODS
611 children referred to the service; 50 children selected from those referred during the first year, whose parents were interviewed and whose general practitioners were invited to complete a questionnaire.


METHODS
Description and costs of service; views of parents and general practitioners of selected sample of children.


RESULTS
In its second year the team received 303 referrals and made 4004 visits at a salary cost of 98000 pounds, an average of 323 pounds/referral and 24 pounds/visit. This represented a referral rate of 3.2% (258/7939) of inpatient episodes from the main referring hospital between 1 December 1989 and 30 November 1990. Of all referrals to the service, 343(56%) came from hospital inpatient wards. The service was used by disadvantaged and ethnic minority families. The children's parents (in 28(61%) families) and the home care team did a wide range of nursing tasks in the home. Parents of 47(94%) children sampled agreed to be interviewed, and those of 43(91%) found the service useful; guidance and support were most commonly appreciated (33, 70%). Parents of 25(53%) children said that hospital stay or attendance had been reduced or avoided. Parents and general practitioners disagreed on clinical responsibility in 10 children, and communication was a problem for some general practitioners.


CONCLUSIONS
The service enabled children to receive advanced nursing care at home. Clinical responsibility should be agreed between parents and professionals at referral.
Wolfson Child Health Monitoring Unit, Institute of Child Health, London.
M A
MA
Tatman
C
C
Woodroffe
P J
PJ
Kelly
R J
RJ
Harris
D001291:Attitude of Health Personnel; D001459:Bangladesh / Q000208:ethnology; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003625:Data Collection; D005006:Ethnicity; D006302:Health Services Research; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008131:London; D010348:Patient Care Team; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010372:Pediatrics; D010821:Physicians, Family; D011204:Poverty Areas; D016730:Program Development; D015397:Program Evaluation / Q000706:statistics & numerical data*; D013222:State Medicine