[Quality, success, and appropriateness of using home care through the Local Health Station No. 13 in Novara].
The research is aimed at evaluating the quality, appropriateness and outcomes of home-care services in the District of Novara of ASL 13, by experimenting a multidimensional model of analysis based on the current clinical records. In this study, we analysed 102 cases of admittance to Integrated Home-care Services (IHS) (50 women and 52 men; average age 72.5). The analysis of the levels of activity highlighted a widespread under-use of the service and an insufficient quality of the clinical records. The management of patients was appropriate in 43.14% of the cases, in terms of intensity and complexity of the received care. 50% of the subjects did not present such characteristics as to need IHS, while 7.86% of the patients evidenced dubious appropriateness, according to an adequate healthcare intensity unaccompanied by a sufficient complexity of the interventions. As far as outcomes are concerned, we were able to highlight how relatively few subjects actually reached the objective of the healthcare plan (26.47%). On the whole, the experimented model of analysis allowed us to trace an effective picture of the quality of the service, by highlighting its critical elements and helping in finding specific actions of improvement.
Panella
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Dip. di Scienze Mediche, Cattedra di Igiene, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Responsabile Struttura Complessa Qualità, ASL no 13, Novara. panella@med.unipmn.it
Sarasino
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D
Demarchi
M L
ML
Minola
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M
D000368:Aged; D019090:Case Management / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D005260:Female; D006077:Government Agencies / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data; D018574:Home Care Agencies / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D011785:Quality Assurance, Health Care