The role of primary care in the organisation of home care services

Abstract

Purpose: To understand the use of primary care and the preference of the patients and the families in order to be registered/included in home care services. Theory: Health care delivery is a complex system that combines many different parties around a shared topic. The “chronic diseases” is a subject topic in medicine that has a great economic and emotional burden with the high hospitalisation rates and palliative care need. All the family members, care givers, health professionals, social security system, pharmacology industry besides the patients are the members of the chronic disease management procedure. Home care is a new area for Turkey that may help this procedure to flow in a more humanistic and cost efficient way. It is beneficial to administer the home care health services from the primary care level but neither the roles and the responsibilities of the health professionals nor the organisational patterns are defined in Turkey. Method: A questionnaire is applied to 46 new respondents of home care about how they learnt about the home care services, their registration way, possible reasons of the problems that they were confronted and their solution suggestions. Findings: Most of the care givers were over 45 years of age (70%), female (61%), with a monthly income of 1500-2500TL (900-1500USD). Most commonly the patients' children or the children inlaw were the caregivers (78%, n=36). Primary health care units and family physicians were the first source of information for the 48% of the participants. Main problems were defined as the lack of coordination and communication of the hospital units with the family physicians (20%) and also with the families (15%) so to be late and inefficiency was the main outcome of dissatisfaction. Discussion: Use of home care services is a new health behaviour for Turkey and “changes” need to convince and motivate the all partners to adopt the new way. So a collaborative study period is needed to be established.