What Should Be Considered When Evaluating the Quality of Home Care? A Survey of Expert Opinions on the Evaluation of the Quality of Home Care in Japan.

Seungwon Jeong,Yusuke Inoue,Hideki Ohta,Takao Suzuki,Yasuyuki Arai

doi:10.3390/ijerph19042361

Abstract

Intending to obtain scientific evidence to use in developing indicators for evaluating the quality of home care, we surveyed doctors, nurses, and other home care professionals to determine the points they consider to be essential in evaluating home care. We investigated all 901 clinics registered to the National Association of Medical Institutions Supporting Home Care and a random sample of 600 Visiting Nurse Service stations registered to the National Association for Visiting Nurse Service in Japan. A total of 539 questionnaire responses were received (response rate: 35.9%). In this study, a factor analysis revealed four factors to be considered when evaluating the quality of home care: (1) patients’ and family members’ level of satisfaction, (2) home care process, (3) structure of home care, and (4) medical outcomes. The factor of the satisfaction of patients and family members identified in the present study was not considered in previous studies for evaluating the quality of care in Japan. Satisfaction is the point of difference in goals between hospital-based care and home care, and it requires different measurement indicators. Home care professionals expect to help relieve the physical and psychological burden felt by the patient and their family. Thus, on the evaluation indicators of quality of home care, their perspectives from the present study are valuable.

Highlights

In Japan, home care is a medical program for people who cannot commute to hospitals on their own, for example, due to decreased activities of daily living caused by illness, injury, or aging or due to disorders arising from dementia or other mental illnesses
We found that doctors and nurses paid particular attention to the satisfaction levels of patients and family members
The present study investigated the viewpoint of home care professionals in evaluating the quality of home care

Summary

Introduction

The aging rate in Japan was 28.4% in 2019. As this rate continues to grow, the Japanese population’s medical and long-term care needs are expected to grow even further. The Japanese Ministry of Health, Labour, and Welfare (MHLW) is building a community-based integrated care system to maintain dignity and support independence and is due to be completed by 2025 [1]. In this system, the community provides comprehensive support and services so that older adults can live the rest of their lives independently in the environment in which they are familiar as much as possible. In Japan, home care is a medical program for people who cannot commute to hospitals on their own, for example, due to decreased activities of daily living caused by illness, injury, or aging or due to disorders arising from dementia or other mental illnesses. As a result of an investigation by the Japanese government, over half of

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