The organisation of paediatric hospital-at-home care: a multi-country comparative study
ISSN: 1476-9018
Article publication date: 31 July 2023
Issue publication date: 10 August 2023
Abstract
Purpose
Many countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries.
Design/methodology/approach
Legal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country.
Findings
Organisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc.
Originality/value
There is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes.
Keywords
Acknowledgements
Funding: This research was funded by the Belgian Health Care Knowledge Centre (KCE), which is financed by the National Institute for Health and Disability Insurance, the Federal Public Service of Health, Food Chain Safety and Environment and the Federal Public Service of Social Security. The development of health services research studies is part of the legal mission of the KCE. Although the development of the studies is paid by the KCE budget, the sole mission of the KCE is providing scientifically valid information.
Citation
Lefèvre, M., Detollenaere, J., Zeevaert, R. and Van de Voorde, C. (2023), "The organisation of paediatric hospital-at-home care: a multi-country comparative study", Journal of Integrated Care, Vol. 31 No. 3, pp. 224-236. https://doi.org/10.1108/JICA-05-2023-0031
Publisher
:Emerald Publishing Limited
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