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.
Tatman
M A
MA
Wolfson Child Health Monitoring Unit, Institute of Child Health, London.
Woodroffe
C
C
Kelly
P J
PJ
Harris
R J
RJ
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