Community Health Care Services Research Articles

Factors Affecting mHealth Technology Adoption in Developing Countries: The Case of Egypt

Mobile health apps are seeing rapid growth in the potential to improve access to healthcare services for disadvantaged communities, while enhancing the efficiency of the healthcare delivery value chain. Still, the adoption of mHealth apps is relatively low, especially in developing countries. In Egypt, an initiative for national-level healthcare coverage was launched in 2021, accompanied by a rise in mHealth start-ups. However, many of these projects did not progress beyond the pilot stage, with very little known about the antecedents of mHealth adoption for the Egyptian user. Semi-structured interviews were conducted with 22 Egyptians, aiming to uncover factors affecting the use of mHealth apps for Egyptian citizens. Some of these factors were introduced by previous studies, such as Perceived Service Quality, Perceived Risk, Perceived Ease of Use, and Trust. Others were not well established in the mHealth research strand, such as Perceived Reputation and Perceived Familiarity, while Governance, Personalized Experience, Explain-ability, Interaction, Language, and Cultural Issues, are novel factors introduced by the current research. The effect of these suggested independent variables on the willingness to adopt mHealth apps was validated using a survey administered to 150 Egyptians, confirming the significant positive effect of most of these factors on mHealth adoption in Egypt. This research contributes to methodology by introducing novel constructs in the mHealth research context, which might be specific to the target developing country. Practical implications were suggested for designers and healthcare service providers might increase the adoption of their apps in developing countries, such as Egypt.

Nigerian and Ghanaian Young People's Experiences of Care for Common Mental Disorders in Inner London: Protocol for a Multimethod Investigation.

The Care Quality Commission published a review in 2018 in England titled "Are We Listening," which revealed that child and adolescent mental health services are not responsive to the specific needs of young Black people and other ethnic minorities even in areas with ethnically diverse populations. It found that commissioners and service planners failed to engage with these young people and their families to understand their needs and expectations. The purpose of this study is to engage Nigerian and Ghanaian young people (NAGYP) with experiences of care for common mental disorders (CMDs) in London, to increase understanding of their needs, and to give voice to their views and preferences. Their parents', caregivers', and practitioners' views will also be sought for service improvement. Three combined contemporary complementary methodologies-thematic analysis, interpretative phenomenological analysis (IPA), and intersectionality-based policy analysis (IBPA)-will be used across 3 comprehensive phases. First, a scoping review where relevant themes will be critically analyzed will inform further phases of this study. Detailed mapping of community and mental health care services in 13 inner London boroughs to investigate what professionals actually do rather than what they say they do. Second, IBPA will be used to scrutinize improving access to psychological therapies and other legislations and policies relevant to NAGYP to undertake an intersectional multileveled analysis of power, models, and constraints. Third, IPA will "give voice" and "make sense" of NAGYP lived experiences of CMDs via a representative sample of NAGYP participants' (n=30) aged 16-25 years, parents or caregivers' (n=20), and practitioners' (n=20) perspectives will be captured. The study has been approved by the UCL Institute of Education Research Ethics Committee (Z6364106/2022/02/28; health research) and University College London (Z6364106/2022/10/24; social research). Recruitment has begun in 13 inner boroughs of London. Data collection through observation, semistructured interviews, and focus groups are expected to be finalized by early 2024, and the study will be published by early 2025. Combining multiple qualitative methodologies and methods will enable rigorous investigation into NAGYP's lived experiences of care received for CMDs in London. Findings from this study should enable a reduction in the negative connotations and harmful superstitions associated with mental health-related issues in this group, inform evidence-based interventions, and facilitate preventive or early access to interventions. There may also be an indirect impact on problems resulting from mental illness such as school dropout, antisocial behaviors, knife crimes, juvenile detention centers, and even death. PRR1-10.2196/42575.

What improves access to primary healthcare services in rural communities? A systematic review

BackgroundTo compile key strategies from the international experiences to improve access to primary healthcare (PHC) services in rural communities. Different innovative approaches have been practiced in different parts of the world to improve access to essential healthcare services in rural communities. Systematically collecting and combining best experiences all over the world is important to suggest effective strategies to improve access to healthcare in developing countries. Accordingly, this systematic review of literature was undertaken to identify key approaches from international experiences to enhance access to PHC services in rural communities.MethodsAll published and unpublished qualitative and/or mixed method studies conducted to improvement access to PHC services were searched from MEDLINE, Scopus, Web of Science, WHO Global Health Library, and Google Scholar. Articles published other than English language, citations with no abstracts and/or full texts, and duplicate studies were excluded. We included all articles available in different electronic databases regardless of their publication years. We assessed the methodological quality of the included studies using mixed methods appraisal tool (MMAT) version 2018 to minimize the risk of bias. Data were extracted using JBI mixed methods data extraction form. Data were qualitatively analyzed using emergent thematic analysis approach to identify key concepts and coded them into related non-mutually exclusive themes.ResultsOur analysis of 110 full-text articles resulted in ten key strategies to improve access to PHC services. Community health programs or community-directed interventions, school-based healthcare services, student-led healthcare services, outreach services or mobile clinics, family health program, empanelment, community health funding schemes, telemedicine, working with traditional healers, working with non-profit private sectors and non-governmental organizations including faith-based organizations are the key strategies identified from international experiences.ConclusionThis review identified key strategies from international experiences to improve access to PHC services in rural communities. These strategies can play roles in achieving universal health coverage and reducing disparities in health outcomes among rural communities and enabling them to get healthcare when and where they want.

Overlooked and under-evidenced: Community health and long-term care service needs, utilization, and costs incurred by people with severe obesity.

Numbers of people with severe obesity (BMI ≥ 40 kg/m2 ), with need for community health and long-term care (LTC) services, are increasing, but documentation is lacking. We identified individuals with severe obesity known to community health and care professionals in a representative United Kingdom region and used an investigator-administered questionnaire to record needs and use of community health and LTC services. Data were verified against health and LTC records. Local and published sources informed detailed micro-costing. Twenty-five individuals (15 women) consented, aged 40-87 (mean=62) years, BMI 40-77 (mean=55) kg/m2 : 20 participants (80%) were housebound. Twenty-two different cross-sector community health and LTC services were used, including community equipment service (n=23), district nursing (n=20), occupational therapy (n=14), and LTC (n=12). Twenty-four (96%) participants used three or more services, with longest care episode lasting over 14 years. Total annual service costs incurred by participants varied from £2053 to £82 792; mean £26 594 (lower estimate £80 064; mean £22 462/upper estimate £88 870; mean £30 726), with greatest costs being for LTC. Individual costs for equipment (currently provided) and home adaptations (ever provided) ranged widely, from zero to £35 946. Total mean annual costs increased by ascending BMI category, up to BMI 70 kg/m2 . This study provides a framework with which to inform service provision and economic analysis of weight management interventions. People with severe obesity may need sustained care from multiple community care services.

The right of access to healthcare: an analysis of how legal and institutional frameworks constrain or facilitate access to healthcare for residents in border areas in the East African Community

BackgroundDespite many countries working hard to attain Universal Health Coverage (UHC) and the Health-related Sustainable Development Goals, access to healthcare services has remained a challenge for communities residing along national borders in the East Africa Community (EAC). Unlike the communities in the interior, those along national borders are more likely to face access barriers and exclusion due to low health investments and inter-state rules for non-citizens. This study explored the legal and institutional frameworks that facilitate or constrain access to healthcare services for communities residing along the national borders in EAC.MethodsThis study is part of a broader research implemented in East Africa (2018–2020), employing mixed methods. For this paper, we report data from a literature review, key informant interviews and sub-national dialogues with officials involved in planning and implementing health and migration services in EAC. The documents reviewed included regional and national treaties, conventions, policies and access rules, regulations and guidelines that affect border crossing and access to healthcare services. These were retrieved from official online and physical libraries and archives.ResultsOverall, the existing laws, policies and guidelines at all levels do not explicitly deal with cross border healthcare access especially for border residents, but address citizen rights and entitlements including health within national frameworks. There is no clarity on whether these rights can be enjoyed beyond one’s country of citizenship. The review found examples of investments in shared health infrastructure to benefit all EAC member countries – a signal of closer cooperation for specialized health care, this had not been accompanied by access rule for citizens outside the host country. The focus on specialized care is unlikely to contribute to the every-day health care needs of border resident communities in remote areas of EAC. Nevertheless, the establishment of the EAC entail opportunities for increased collaboration and integration beyond the trade and customs union to included health care and other social services. The study established active cooperation aimed at disease surveillance and epidemic control among sub-national officials responsible for health and migration services across borders. Health insurance cards, national identification cards and official travel documents were found to constrain access to health services across the borders in EAC.ConclusionIn the era of UHC, there is need to take advantage of the EAC integration to revise legal and policy frameworks to leverage existing investments and facilitate cross-border access to healthcare services for communities residing along EAC borders.

Roadmap for developing acute community health care services – illustrated with the development in Danish municipalities

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

The role of cultural safety and ethical space within postcolonial healthcare for Maasai in Tanzania

The history of the Maasai tribe in northern Tanzania is characterised by marginalisation, discrimination and political subjugation. Inequities, enacted through power relations, influence healthcare access, practices and outcomes among the...

Joint use between communities and schools: unpacking dimensions of power

ABSTRACT What explains the level of joint use service delivery between communities and schools? Using a 2019 nation wide survey of 996 US local governments, we assess the community level factors that lead to more joint use services with schools. These include services for children (child care, child nutrition for evenings, weekends, summer), adults (adult education, nutrition programs, school buses to transport seniors), and the entire community (recreation and health care services for all ages). We identify key factors that differentiate more joint use services. We measure two types of power – hierarchical power over, and horizontal power with. We find power with (partnership and formal joint use agreements) is more important than power over (local government siting and budget control over schools). We also find engagement of families and seniors in the planning process can lead to a common vision, and this also leads to more joint use services with schools.

Effect of acrreditation status and health insurance on satisfaction of community health centres service quality in Ngawi, East Java, Indonesia

Indonesia's healthcare system is in progress, and has tried to make many improvements in its healthcare delivery system and has brought out many reforms. Several studies show the relationship between patient satisfaction and quality of health services, but none sufficiently analyze the association between acrreditation status and health insurance with satisfaction among patients. This study aimed to investigate the effect of acrreditation status and health insurance on satisfaction of quality in Community Health Care services (PUSKESMAS) in Ngawi, East Java. We conducted a cross-sectional study in all community health care services in Ngawi, East Java. A total 200 outpatients selected by simple random sampling. We analyze the association of community health care accreditation status, and health insurance adjusted with age, education level, and income of respondents with the satisfaction of quality of care from community health care services using multivariate logistic regression by STATA 16. Respondents visited accredited community health care (aOR= 1.60; 95% CI= 1.13 to 2.27; p<0.07) have higher odds of satisfaction with the quality of care in community health care services compared to respondents visited non-accredited community health care and with age less than 35 years, respectively.

The Factors Influencing Public Satisfaction with Community Services for COVID-19: Evidence from a Highly Educated Community in Beijing.

The satisfaction of highly educated citizens with community services for COVID-19 represents the attitude of the middle class and plays an important role in both the social and political stability of a country. The aim of this paper was to determine which factors influence public satisfaction with COVID-19 services in a highly educated community. Through a literature review and using the American Customer Satisfaction Index (ACSI) model, this paper constructed a public satisfaction model of community services for COVID-19 and proposed relevant research hypotheses. A community with many highly educated residents in Beijing was selected as the case study, where 450 official questionnaires were distributed based on the age ratio of residents, with 372 valid questionnaires being collected from May 2021 to July 2021. The study results obtained by a structural equation model (SEM) show that: (1) public satisfaction is significantly and positively influenced by quality perception (0.305 **), public demand (0.295 **), and service maturity (0.465 ***); (2) public satisfaction has a significantly positive effect on service image (0.346 ***) and public trust (0.232 **), and service image significantly affects public trust (0.140 *); (3) service maturity is positively influenced by public demand (0.460 ***) and quality perception (0.323 *); and (4) public demand is positively influenced by quality perception (0.693 ***) (* p < 0.05; ** p < 0.01; *** p < 0.00). The conclusions of the study can provide suggestions and recommendations to improve the satisfaction of highly educated residents with community healthcare services during the COVID-19 pandemic.

Examining the gender imbalance in the National Community Health Assistant Programme in Liberia: a qualitative analysis of policy and Programme implementation.

The Revised National Community Health Services Policy (2016-2021) (RNCHSP) and its programme implementation, the Liberian National Community Health Assistant Programme (NCHAP), exhibit a critical gender imbalance among the Community Health Assistants (CHAs) as only 17% are women. This study was designed to assess the gender responsiveness of the RNCHSP and its programme implementation in five counties across Liberia to identify opportunities to improve gender equity in the programme. Using qualitative methods, 16 semi-structured interviews were conducted with policymakers and 32 with CHAs, other members of the community health workforce and community members. The study found that despite the Government of Liberia's intention to prioritize women in the recruitment and selection of CHAs, the planning and implementation of the RNCHSP were not gender responsive. While the role of community structures, such as Community Health Committees, in the nomination and selection of CHAs is central to community ownership of the programme, unfavourable gender norms influenced women's nomination to become CHAs. Cultural, social and religious perceptions and practices of gender created inequitable expectations that negatively influenced the recruitment of women CHAs. In particular, the education requirement for CHAs posed a significant barrier to women's nomination and selection as CHAs, due to disparities in access to education for girls in Liberia. The inequitable gender balance of CHAs has impacted the accessibility, acceptability and affordability of community healthcare services, particularly among women. Strengthening the gender responsiveness within the RNCHSP and its programme implementation is key to fostering gender equity among the health workforce and strengthening a key pillar of the health system. Employing gender responsive policies and programme will likely increase the effectiveness of community healthcare services.

First, do no harm: why anti-immigrant policies in the United States are a public health concern.

It can be argued that anti-immigrant policies, such as the 287(g) program, can have a direct impact on the health and well-being of the immigrant community in general, particularly undocumented immigrants in the United States. While there is yet to be a comprehensive and conclusive empirical assessment of this issue, what is known is that the immigrant community faces many stress factors and structural barriers that negatively impact health. We argue that it is urgent that public health responds to the unique experiences and challenges of the undocumented and wider immigrant community. In doing so, we propose three recommendations for addressing this issue: (1) Assess the causal relationship between anti-immigration policies and immigrant health, (2) Increase funding and access to health care services for immigrant communities in jurisdictions implementing anti-immigrant policies, and (3) For public health to engage in a conscious effort to service the undocumented immigrant community. Even though we focus specifically on the United States, our recommendations are applicable on a global scale since anti-immigration policies are prevalentacross nations and are a pervasive human rights issue around the world.

Home-dwelling older adults’ experiences of living with both frailty and multimorbidity: A meta-ethnography

ObjectivesTo systematically review qualitative studies about home-dwelling older adults’ experiences of living with both frailty and multimorbidity. MethodsThis study adopted a meta-ethnography; the databases included PubMed, Embase, CINAHL, Web of Science, PsycINFO, SCOPUS, and Google Scholar. Qualitative peer-reviewed articles in English were searched up to December 31, 2021. Themes and concepts were extracted through constant comparison across the included studies by three reviewers. ResultsOf the 147 articles screened, nine qualitative articles, encompassing a total sample of 173 participants, were included. The four final synthesised themes were ‘Being isolated in a closed life,’ ‘Being dependent on help from others,’ ‘Rebuilding to maximise quality of life,’ and ‘Struggling to live a meaningful life.’ ConclusionHome-dwelling older adults with both frailty and multimorbidity are more likely to be socially isolated due to their physical limitations and lack of integration between hospital-based care and community healthcare services.

Development of China's health care system in the time of COVID‐19: Challenges, opportunities, and call for actions

Development of China's health care system in the time of COVID‐19: Challenges, opportunities, and call for actions

Recognise and Acknowledge Us: Views of Traditional Birth Attendants on Collaboration with Midwives for Maternal Health Care Services.

Background Traditional birth attendants have since ancient time provided care to pregnant women. As such, the collaboration between midwives and traditional birth attendant (TBAs) can be an essential effort towards the reduction of the maternal and neonatal mortality and morbidity rate especially in low- and middle-income countries (LMICs). This paper argues that the collaboration between traditional and formal health systems expands the reach and improves outcomes of community health care. The study is aimed at exploring the traditional birth attendant's views on collaboration with midwives for maternal health care services at selected rural communities in South Africa (SA). Methods The study was conducted in two rural communities in Tshwane and Johannesburg metropolitan districts from 15 June to 31 October 2021. The study followed the qualitative explorative and descriptive research design. The sampling technique was nonprobability purposive, and snowballing technique was also used to sample the key informants who are the traditional birth attendants also known as traditional healers and who provide maternal health care services in the respective communities. The access to these participants was through the gatekeepers, the Traditional Health Organisation Council (THO) council. Data collection was through semistructured in-depth interviews. Data were analysed thematically through the eight steps of Tesch. Results Five main themes were identified which included the recognition of traditional birth attendants as enablers of collaboration, the envisaged value of the collaboration, processes required to foster collaboration, repositioning for new roles, and barriers to collaboration. Conclusion The TBAs are ready to collaborate with the formal health care system, and all they require is for their services to maternal health care to be recognised and acknowledged.

Understanding Differences in Behaviour Patterns of Healthcare Service Elements Among Regions Applying Data Mining

Maternal and child healthcare (MCH) has always been regarded as one of the important issues globally. The aim of this article is to find out all frequently occurring healthcare service elements along with their availability conditions and their interactions with other health system (HS) elements, when coverage of priority MCH intervention was either poor or moderate or good in any region. Association rule mining technique has been used to understand the probability of occurrences of different healthcare service elements among regions. Along with the proposed analytical framework, an interactive decision support system (DSS) has also been developed on a web platform, which would help healthcare policymakers to integrate the analytical framework easily in their processes of decision-making. The system has been developed by using Shiny package on R software. Data for all variables are collected for 584 Indian districts from the third phase of district-level household and facility survey. From results, it is observed that community healthcare services, sub-centre (SC)-level healthcare services and PHC-level healthcare services of a region are very much interlinked with each other, and their relationships define the healthcare condition of that region.

Association Between Positive Mental Character and Humanistic Care Ability in Chinese Nursing Students in Changsha, China.

AimTo investigate the status of positive mental characters and humanistic care ability among Chinese nursing students, and confirm the association between positive mental characters and humanistic care ability.MethodsA cross-sectional survey was conducted. Nine hundred eighty-one Chinese nursing students were recruited from hospitals and community healthcare services in Changsha, Hunan, China. Three different self-reported questionnaires were applied: The Demographic Characteristics Questionnaire, Humanistic care ability of Nursing Undergraduates Assessment Scale and Positive Mental Characters Scale for Chinese College Students. Pearson correlation analysis and multiple liner regression analysis were performed to analyze the association between positive mental character and humanistic care ability for Chinese nursing students.ResultsThe mean scores of nursing students' humanistic care ability and positive mental character were 125.94 ± 21.19, 233.18 ± 38.59, respectively. The Pearson correlation results showed that positive mental character (r = 0.655, P < 0.001) was significantly associated with humanistic care ability. Multiple liner regression analysis indicated that positive mental characters, four dimensions of courage, humanity, justice and transcendence in positive mental character, care from classmates were found to be independent predictors of humanistic care ability.ConclusionPositive mental characters are important considerations in the development, implementation and evaluation of humanistic care ability interventions.

Judgements of physicians, nurses, and social workers regarding suspected Child maltreatment in community health care services.

This study investigated how physicians, nurses, and social workers in community health care services make judgements about possible child maltreatment in ambiguous situations. We examined the influences of social biases (i.e., perceptions linking ethnicity, gender, and family socioeconomic status to child maltreatment) and belonging to distinctive occupational groups (i.e., physicians, nurses, and social workers) on professionals' assessment of suspected child maltreatment, intention to consult with others, and reporting. We used an experimental survey design including vignettes presenting a child's history inspired by real-life clinical cases. Data were collected from 397 health care professionals-170 physicians, 179 nurses, and 48 social workers-employed at community health care clinics in northern Israel. Findings show that the child's gender and family socioeconomic status had significant effects on assessment of possible child maltreatment. Also, professionals' occupational group had significant effects on assessment of child maltreatment and intention to pursue consultation. Another key finding was the significant effects of judgements about child maltreatment assessment, consultation, and reporting on one another. The study reinforces efforts to improve health care professionals' management of suspected child maltreatment that include the development of clinical decision support systems that use routinely collected electronic medical record data.

Conditions for Feasibility of a Multicomponent Intervention to Reduce Social Isolation and Loneliness in Noninstitutionalized Older Adults.

Aims: To identify the factors conditioning the feasibility of an intervention to reduce social isolation and loneliness in noninstitutionalized older adults from the perspective of the intervention agents. Design: A Dimensional Grounded Theory study conducted from December 2019 to January 2020. Methods: Twelve participants were recruited from an experimental study developed in a health district of a southern Spanish city. Data were collected through focus group meetings, individual interviews, biograms, anecdote notebooks, and the field diaries of two participants not included in the other techniques. Transcripts were analyzed using thematic analysis. Findings: Findings were divided into three themes: (a) the elderly between the walls of loneliness, economic difficulties, losses, and the past; (b) intervention agents/volunteers between the walls of inexperience in the management of psychological/emotional processes, lack of moral authority, and difficulty in planning results adapted to the (elderly) person; and (c) intervention between the walls of (interest in) company and assistance at home, lack of involvement (“waiting for you to save them”), and withdrawal/“abandonment”. Conclusion: A profile of the specialized intervention agent, professionalized (or at least a mentored agent), with both technical and relational competencies; a clear understanding of the purposes of the intervention (empowerment, as opposed to having company or being helped with household chores) and the commitment to active participation by the elder; or adequate management of the completion of the intervention (flexibility, attachment management) are some of the main factors contributing to the feasibility of these approaches. Impact: The findings have potential implications in the field of primary healthcare because primary and community healthcare services can implement corrections to the proposed intervention and ensure its effectiveness under feasible conditions. The nurse is shown as the most appropriate profile to conduct this intervention, although more research is needed to analyze the feasibility of this type of intervention in the daily practice of community nurses.

Uniformity and comparability of national Health Information Systems for home care, nursing homes, and hospices in Italy

Health Information Systems (HIS) play a strategic role in the development of community healthcare services, a field still underdeveloped in Italy as shown by the COVID-19 pandemic, and their use for epidemiological purposes is increasing over the years. However, some general critical issues have been reported concerning national community health information systems, but no detailed study was found after a non-systematic review in Medline database and institutional websites. to assess uniformity and comparability of health information collected by the national health information Systems for Home Care (SIAD), Nursing Homes (FAR), and Hospices (HOS) in Italy, three healthcare settings sharing patients with common conditions and healthcare needs. information was gathered from current Technical Regulations Papers of the Italian Health Ministry. All variables of the three Information Systems were ordered on the basis of the characteristics provided by the ministerial documents into a single grouping model created for the purpose and their distribution compared among and between the Systems. According to the grouping model, the variables were divided in two main groups: System Variables for administrative, bill, and identification-personal data and the Pathway Variables for patient's conditions and provided healthcare data. Common information content variables among all systems and between two of them were then identified, highlighting those with also identical terminology and allowed values. On the basis of the percentages of common and identical variables, uniformity in content and terminology was then calculated among all systems and between two of them. Besides, levels of content and terminology agreement have been calculated with Cohen's K matching the three Systems in all possible combinations of pairs. there are 70 variables in SIAD, 45 variables in FAR, and 34 in HOS. System variables are nearly the half in FAR and HOS, 22 (48.9%) and 17 (50.0%) variables, respectively. Pathway variables are prevalent only in SIAD, with 55 variables (78.6%). Only SIAD and HOS use ICD-9-CM, with 2 (2.8%) and 9 (26.5%) variables, respectively. The three Systems share 18 common variables, with other 16 common between just two of them. Considering the common variables, the total number of variables used by all the Systems is 97, with 23 System variables (23.7%) and 74 Pathway variables (76.3%). Overall, content uniformity among the three Systems is 18.5%, but becomes 60.9% considering only the System variables and 5.4% for the Pathway variables, with respectively 14 and 4 common variables. Among the common variables, 11 have the same denomination and allowed values, with an overall terminological uniformity of 11.3%. Being all of them System variables, no terminological uniformity has been found among the three Systems.The level of content agreement was fair for the couple FAR-HOS (K Cohen 0.26), but null for HOS-SIAD and SIAD-FAR (K Cohen -0.20 and <0.01). Null was also the level of terminological agreement in all the possible pairs of matched systems (K Cohen all negative). content and terminology uniformity of National Health Information Systems in Italy for Home Care, Nursing Homes, and Hospices has been found to be poor, with little reference to standardised classification systems and a scarce level of comparability of the information gathered in the three healthcare settings, although similarity in patients' characteristics and provided health services. Data comparability among them is mainly limited to administrative and identification-personal information, with little possibility of comparing information on patients' conditions and provided healthcare in the three settings. This scarce uniformity might undermine the contribution of national Health Information Systems in the development of community healthcare services in Italy and limit the potential of epidemiological research in this area. Also in the light of the establishment of new national Health Information Systems for Primary Care and Community Hospitals, a methodological reassessment of languages, codes, and evaluation tools used by community health services and information systems is needed.