diminish in availability and capacity. Even where evidence-based support for home care is available, patients and family caregivers should remain at liberty to choose the place of care and death. Need to support families better in making an informed decision between home vs. institutional care, acknowledging that preferences may change over time and may differ for patients vs. caregivers and place of care vs. place of death. Parker et al. (2012). 1. Care closer to Home: 4. Children care. Samples 8. Paediatric home care has 10. Care closer to home 13. See Q14 “any model of care in studies ranged from 15 equivalent clinical outcome offers potential for UK that acted to prevent to 210. results to in-patient hospital reduced health service 14. Research: Areas for immediate inpatient treatments e.g. Weight gain in costs, but this is further investigation on Systematic Rev.iew (n= 37 admission and/or enable a 5. Long-term conditions/ premature infants; HBA1C for sensitive to case mix, care closer to home (CCTH) papers on 26 studies of reduced length of stay for short term health needs/in diabetes care; Adaptation to skill mix and change in in minority communities or which 11= RCTs & 15 = children (up to the age of need of palliative care. school 7 work re mental health the local health socio-economically health economic studies) 18 years) with acute, problems; Readmissions to economy. deprived groups and in chronic, complex or 6. Home care. hospital; Adverse events from rural areas. Consider palliative care needs” (p. 3). chemotherapy. 11. NR. factors influencing 7. NR for some studies whether families feel able 2. Most common model is reviewed. Nurses/primary Costs: Savings associated with 12. NR. to use CCTH services, the generic community care provider/case paediatric home care. views of children about children’s nursing teams & manager where reported. service and and the impact condition specific services, 9. NR. of CCTH on primary and nurse led only or community care services. multidisciplinary teams.
diminish in availability and capacity. Even where evidence-based support for home care is available, patients and family caregivers should remain at liberty to choose the place of care and death. Need to support families better in making an informed decision between home vs. institutional care, acknowledging that preferences may change over time and may differ for patients vs. caregivers and place of care vs. place of death. Parker et al. (2012). UK Systematic Rev.iew (n= 37 papers on 26 studies of which 11= RCTs & 15 = health economic studies) 1. Care closer to Home: “any model of care that acted to prevent immediate inpatient admission and/or enable a reduced length of stay for children (up to the age of 18 years) with acute, chronic, complex or palliative care needs” (p. 3). 2. Most common model is generic community children’s nursing teams & condition specific services, nurse led only or multidisciplinary teams. 4. Children care. Samples in studies ranged from 15 to 210. 5. Long-term conditions/ short term health needs/in need of palliative care. 6. Home care. 7. NR for some studies reviewed. Nurses/primary care provider/case manager where reported. 8. Paediatric home care has equivalent clinical outcome results to in-patient hospital treatments e.g. Weight gain in premature infants; HBA1C for diabetes care; Adaptation to school 7 work re mental health problems; Readmissions to hospital; Adverse events from chemotherapy. Costs: Savings associated with paediatric home care. 9. NR. 10. Care closer to home offers potential for reduced health service costs, but this is sensitive to case mix, skill mix and change in the local health economy. 11. NR. 12. NR. 13. See Q14 14. Research: Areas for further investigation on care closer to home (CCTH) in minority communities or socio-economically deprived groups and in rural areas. Consider factors influencing whether families feel able to use CCTH services, the views of children about service and and the impact of CCTH on primary and community care services.
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