Abstract
Growing demand of care for chronic and/or elderly patients has resulted in a need to expand formal care services for the health systems. In consequence, some countries are making efforts to stimulate community living and care, which includes home-based care (HBC). Our purpose was to describe the regulation of home care services in Europe (Austria, Belgium, Czech Republic, France, Germany, Italy, Poland, Russia, Spain, The Netherlands and United Kingdom) and Latin America (Argentina, Brazil, Colombia and Mexico), including legislative or guidelines-bases framework and national standards. A search on grey literature was performed. Search terms (in English and Spanish) including “home care services”, “medicine home delivery” and “drug distribution” associated with specific terms related to regulation and specific country name were run. All European countries except Russia offer total or partial coverage for home services. Only Belgium, France, Italy and Spain contemplate full financing of home care services, which are provided by their National Health Systems and are not subject to any patients’ cost-sharing. Most home healthcare programs explicitly include nurse services (Austria, Belgium, Czech Republic, Germany, Italy and The Netherlands). With regards to regulation of distant selling or delivery of medicines, most countries (n=9; 81.8%) only allow online sale of over-the-counter medicines. Only in The Netherlands, general practitioners can prescribe drugs online in certain circumstances, (i.e. in an emergency). All Latin American countries have rehabilitation and long-term care programs which are financed by their health systems. However, the level of coverage is very low. The regulation of distant selling or delivery of medicines is quite heterogeneous. The scarcity of up-to-date information on home care policy contrasts with its importance. There is great variation between countries in regulation, financing, delivery and availability. In addition, in several countries home-care policy is not well articulated and does not meet the demand for HBC.
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