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Home health care could help sustain health
care systems, study finds
December 8, 2010--Home health care
technology may provide one important
solution to global concerns about how to
sustain health care systems threatened by
rising costs and manpower shortages, but
such a change faces multiple obstacles to
adoption, according to a new RAND
Corporation study.
The study finds that a wide array of health
care stakeholders agree that expanding
home-based health tools could give patients
a greater ability to self-manage their
conditions in partnership with their medical
providers, and help improve their health and
overall well-being.
However, moving care to patients' homes
would be a major shift in the structure of
health care and can be accomplished only if
consensus is reached between patients,
health care providers, insurance companies
and policymakers, according to the report.
"The aging of the world's population and
fact that more diseases are treatable will
create serious financial and manpower
challenges for the world's health care
systems," said Dr. Soeren Mattke, the
study's lead author and a senior natural
scientist at RAND, a nonprofit research
organization.
"Moving more health care into the home
setting where patients or family members can
manage care could be one important solution
to these challenges."
The findings are from a global study of the
needs, expectations and priorities regarding
home health care among key stakeholders in
six countries -- China, France, Germany,
Singapore, the United Kingdom and the United
States.
Researchers conducted interviews with
government officials, regulators, providers,
insurers, manufacturers, distributors and
patient organizations, as well as reviewing
existing research about home health care.
An increase in the world's elderly
population, coupled with better treatment
for many diseases, is expected to increase
the number of people living with chronic
conditions and disability in the decades
ahead, putting pressure on the finances and
the workforce of health care systems.
In the United States, for example, people
age 64 and older account for 12 percent of
the population, yet incur 34 percent of the
nation's total health care spending.
While this trend started in the developed
world, it is increasingly affecting
developing and transitional nations. For
example, Singapore has become the world's
most rapidly aging country and already 80
percent of all deaths in China are caused by
chronic disease.
Home health care is an attractive solution
because it empowers patients to self-manage
their conditions to a greater extent and
helps to shift care from high-cost
institutional and professional settings to
patients' homes and the community.
Such a change could both save money and ease
pressure on health systems suffering from
worker shortages and capacity constraints,
researchers say.
Home health care technology spans a broad
spectrum from basic diagnostic tools, such
as glucose meters, to advanced telemedicine
solutions.
Those advances have pushed the frontier of
care management further into the home
setting. The advances have the potential to
not only support current care delivery, but
to fundamentally change the model to a more
efficient and more patient-centered one,
according to the report. Home care also
makes it easier for patients to age in
place, if they prefer, and avoid
institutionalization.
Despite the promise of expanding home health
care, these technologies face a number of
barriers to adoption.
Restrictive insurance coverage and existing
incentives for in-person home care creates
obstacles, as does limited patient readiness
because of insufficient health literacy,
according to the study.
Concerns about audience-appropriate product
design and support, and limited information
about whether the technology is effective
and efficient also poses barriers to
adoption.
While there are signs that home health care
increasingly is on the radar of policymakers
in many countries, researchers say that both
the policy environment and the products
themselves must be redesigned to realize the
potential benefits.
Policymakers will have to develop a vision
for the appropriate role of home health care
and drive the agenda to implement that
vision, the study says.
Key components of that agenda will be the
alignment of payment systems and incentives
with policy goals, clarification of the
regulatory framework for home health care
technology, and efforts to promote patient
receptiveness for new models of care
delivery.
Manufacturers will need to develop
affordable products with intuitive designs
that meet patient needs, provide ongoing
support for patients and their families, and
integrate services and data with those of
other professional care providers.
Companies also must provide evidence for the
clinical and cost-effectiveness of home care
products, while health care providers will
need to embrace a new role as partners of
their patients in the care process, rather
than paternalistic caregivers, according to
researchers.
###
Support for the study was provided by Royal
Philips Electronics, a global leader in home
health care technology.
The report, "Health and Well-Being in the
Home: A Global Analysis of Needs,
Expectations, and Priorities for Home Health
Care Technology," is available at www.rand.org.
Other authors of the report are Lisa
Klautzer, Todi Mengistu, Jeff Garnett,
Jianhui Hu and Helen Wu.
RAND Health, a division of the RAND
Corporation, is one of the world's largest
independent health policy research program,
with a broad research portfolio that focuses
on quality, costs and health services
delivery, among other topics.