The Effects of Home Care Provider Mix on the Care Recipient: An International, Systematic Review of Articles from 2000 to 2020.

Norma B Coe,Melissa Berkowitz,R Tamara Konetzka,Emily Blecker,Courtney H Van Houtven

doi:10.1146/annurev-publhealth-090419-102354

Norma B Coe, Melissa Berkowitz + Show 3 more

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https://doi.org/10.1146/annurev-publhealth-090419-102354

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Abstract

In this systematic review, we examine the literature from 2000 to 2020 to ascertain whether we can make strong conclusions about the relative benefit of adding informal care or formal care providers to the care mix among individuals receiving care in the home, specifically focusing on care recipient outcomes. We evaluate how informal care and formal care affect (or are associated with) health care use of care recipients, health care costs of care recipients, and health outcomes of care recipients. The literature to date suggests that informal care, either alone or in concert with formal care, delivers improvements in the health and well-being of older adults receiving care. The conclusions one can draw about the effects of formal care are less clear.

Highlights

IntroductionLong-term care (sometimes referred to as long-term services and supports in the literature) is important and growing
We have categorized the rest of this review on the basis of the treatment and comparator groups in the studies: assessing outcomes of informal care compared with outcomes of formal care, assessing outcomes of informal care in the presence of formal care, assessing outcomes of formal care in the presence of informal care, and assessing the heterogeneity of the effects of care on the basis of care combinations
One assumes that formal care providers such as home health aides are better trained than informal caregivers, little formal training, especially ongoing training, is required to become a home health aide

Summary

Introduction

Long-term care (sometimes referred to as long-term services and supports in the literature) is important and growing. Patient advocates raised patient well-being concerns and the desire to provide care in the least restrictive setting possible, and laws supporting this desire followed [e.g., the Americans with Disabilities Act (ADA) and the subsequent U.S Supreme Court ruling on Olmstead v. The Olmstead ruling held that people with disabilities have a qualified right to receive state-funded supports and services in the community rather than in institutions when the person’s care team determines that community supports are appropriate, the person does not object to living in the community, and the provision of services in the community would be a reasonable accommodation when balanced with other situated individuals with disabilities. Increased longevity and strained budgets have led policy makers to advocate for increased reliance on receiving care at home, instead of at nursing homes, where at least some of the care is provided by family [67] and friends and not part of either Medicare’s or Medicaid’s budget

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