Evaluation of the functioning of long-term at-home nursing care in Poland from the perspective of care providers: Mixed methods study.

Abstract

This study aimed to analyse and evaluate the functioning of long-term at-home nursing care (LTHNC) based on the opinions of its service providers. Long-term at-home nursing care is a form of care for patients who do not need hospital treatment but need systematic nursing care because of their health problems. LTHNC in Poland involves guaranteed care services financed from universal health insurance contributions pursuant to contracts with the National Health Fund (NHF); the program has existed since 2004. A sequential-explanatory mixed-method design was used. The study was carried out using both quantitative and qualitative research methods. A questionnaire was distributed amongst 1119 care providers (the response rate was 38.2%). The qualitative research comprised semi-structured interviews with ten care providers, namely three nurses managing LTHNC facilities and seven nurses directly providing services as part of LTHNC. The STROBE checklist was used in reporting this study. We found that the main reasons for contracting LTHNC services were the increasing demand for this form of care, financial motives and an opportunity to introduce new organisational solutions. Our study shows that LTHNC is beneficial not only for the patients, but also for the nurses who provide the care. On the one hand, LTHNC provides positive results for patients and their caregivers (family members), and on the other hand, it affords a sense of satisfaction to the nurses and contributes to the development of their professional independence. According to care providers, improving accessibility through increasing the number of contracted services as well as raising the pay for 1day of care per patient may improve the functioning of LTHNC. The results of our study are a source of information for those who organise health care and administer resources on how to improve the functioning of LTHNC.