In-home Healthcare Research Articles

Inpatient Service Use by Type of Health Coverage Scheme in South Korea: A Secondary Analysis of National Data

Background: Healthcare utilization has progressively increased, especially among Medical Aid (MA) beneficiaries in South Korea. Recently, the focus of MA policy is shifting to long-term inpatient management. We aimed to identify the factors associated with inpatients’ medical service use among MA beneficiaries compared to National Health Insurance (NHI) beneficiaries. Methods: This secondary data analysis study used raw data collected from 2012 to 2014 by the Korea Health Panel Study, which is a national health survey conducted annually. Data from 3,869 participants were analyzed: 3,621 NHI beneficiaries and 248 MA beneficiaries. Multiple regression analysis and difference and slope difference tests were performed. Results: Age, education level, marital status, living with family, employment, disability, and unmet medical needs significantly influenced the length of hospital stay. Living with family, employment, disability, chronic illness, and unmet medical needs significantly influenced hospitalization costs. MA beneficiaries had longer hospital stay than did NHI beneficiaries (F=5.99, P=0.003); however, there was no difference in hospitalization costs. Among those with low education, longer hospital stay length was more frequent among MA beneficiaries. Conclusion: A future intervention model for MA inpatients should consider their service use patterns and characteristics. Most importantly, healthcare education should be provided according to MA patients’ education level to enable patients to make informed health-related decisions. An effort is needed to change the current hospitalization system by encouraging patients to utilize local community care service and by expanding community care and in-home healthcare services.

Evde Sağlık Hizmetlerinin Araştırılması ve Hasta ve Hasta Yakınlarının Beklentileri: Bakırköy'de Bir Araştırma Örneği

Aim: The aim of this study is to examine the expectations and demands of patients and their relatives' in-home health care. In the scope of the study, narrow area as the study was being carried out in the Bakirkoy district of Istanbul province.Method: In the scope of the study, questionnaires were distributed to 83 people in Istanbul who were satisfied with home health care services, but 70 people were returned. The analysis was conducted on 70 people. The research is a descriptive survey model. A questionnaire was used as a data collection tool. The questionnaire forms consist of questions about demographic and home health service evaluation scale. Results: When the opinions of the patients and their relatives were evaluated in terms of home care services, the mean values of all expressions in the home health service evaluation questionnaire were over 4. Conclusion: This indicates that patients who are receiving home care services and their relatives have positive perceptions about home care services. The satisfaction of the patients and their relatives are very high for home care services.

Ultrasonic Transdermal Delivery System with Acid-Base Neutralization-Generated CO2 Microbubble Cavitation.

Transdermal delivery systems provide a convenient noninvasive approach for drug administration through the skin, and they have been widely developed for in-home health care. The stratum corneum of the skin surface limits drug penetration, but ultrasound (US)-stimulated microbubble (MB) cavitation can enhance skin permeability to promote transdermal drug penetration. However, the specific materials and complex fabrication of MBs influence the scope of application in transdermal delivery systems. Hence, we studied the mixture of citric acid and NaHCO3 agents to generate shell-free CO2-MBs by acid-base neutralization effect. The generation rate of CO2-MBs was 36.3 ± 10 MBs/s and the mean size was 110 ± 14 μm under US sonication (3.1 MHz, 0.5 W/cm2, 50% duty cycle, 1 min). The penetration of Evans blue and FITC-conjugated hyaluronic acid in rat abdominal skin by CO2-MB cavitation improved 2.4 ± 0.3 and 2.1 ± 0.1 fold, respectively. The penetration depth of Evans blue (27.1 ± 5.1 μm) reached the epidermal layer, providing the potential for inducing transcutaneous immunization. Therefore, we proposed a simple and self-operating ultrasonic transdermal delivery system with CO2-MB cavitation to improve drug penetration for in-home health care development.

Nasogastric tube feeding versus assisted hand feeding in-home healthcare older adults with severe dementia in Taiwan: a prognosis comparison

BackgroundAll individuals with severe dementia should be offered careful hand feeding. However, under certain circumstances, people with severe dementia have a feeding tube placed. In Taiwan, tube feeding rate in demented older home care residents is increasing; however, the benefits of tube feeding in this population remain unknown. We compared the clinical prognosis and mortality of older patients with severe dementia receiving nasogastric tube feeding (NGF) or assisted hand feeding (AHF).MethodsData from the in-home healthcare system between January 1 and December 31, 2017 were analyzed to identify 169 participants over 60 years of age in this retrospective longitudinal study. All subjects with severe dementia and complete functional dependence suffered from difficulty in oral intake and required either AHF or NGF. Data were collected from both groups to analyze pneumonia, hospitalization, and mortality rates.ResultsA total of 169 subjects (56 males and 113 females, aged 85.9 ± 7.5 years) were analyzed. 39 required AHF and 130 NGF. All subjects were bedridden; 129 (76%) showed Barthel index < 10. Pneumonia risk was higher in the NGF group (48%) than in the AHF group (26%, p = 0.015). After adjusting for multiple factors in the regression model, the risk of pneumonia was not significantly higher in the NGF group compared with the AHF group. One-year mortality rates in the AHF and NGF groups were 8 and 15%, respectively, and no significant difference was observed after adjustment with logistic regression (aOR = 2.38; 95% CI, 0.58–9.70). There were no significant differences in hospitalization rate and duration.ConclusionsFor older patients with dementia requiring in-home healthcare, NGF is not associated with a significantly lower risk of pneumonia than AHF. Additionally, neither mortality nor hospitalization rates decreased with NGF. On the contrary, a nonsignificant trend of increased risk of pneumonia was observed in NGF group. Therefore, the benefits of NGF are debatable in older patients with severe dementia requiring in-home healthcare. Continued careful hand feeding could be an alternative to NG feeding in patients with severe dementia. Furthermore, large-scale studies on in-home healthcare would be required to support these results.

From Signal to Image: Capturing Fine-Grained Human Poses With Commodity Wi-Fi

Human sensing based on commodity Wi-Fi devices has become a promising technique in human tracking, gesture recognition, walking speed monitoring, in-home healthcare, etc. However, past human sensing systems usingWi-Fi capture limited information about humans. Hence in this letter, we try to make commodity Wi-Fi devices act as cameras to directly capture human poses, i.e., fine-grained human skeleton images. We use a synchronized camera to capture human skeletons as annotations for Wi-Fi signals and design a novel neural network to convert Wi-Fi signals into images. We utilize three transceivers coordinately and use amplitude and phase information of Channel State Information (CSI) jointly to improve the resolution of Wi-Fi signals. We also introduce a method to extract useful and accurate CSI corresponding to humans and construct CSI images which are input of the neural network. Experimental results show that commodity Wi-Fi devices can capture human poses almost as fine-grained as cameras.

Сравнительный анализ состава пациентов дневных стационаров и стационаров на дому

The aim. To conduct a comparative analysis of the composition of patients in day hospitals and in-home health care by medical organizations providing outpatient care by age groups and classes of diseases in the Russian Federation for 2011-2019, to submit proposals for making additions to the report form. Material and methods. The data from the report form of sectoral statistical observation № 14ds "Information on the activities of day hospitals of medical organizations" on the composition of patients treated in day hospitals and in-home health care by medical organizations providing outpatient care, by age and classes of diseases for 2011-2019 were analyzed. Since 2019, the report form has provided consolidated information on the work of day hospitals and in-home health care. Based on the results of the performed in-depth study, a separate composition of patients in day hospitals and in in-home health care in the Russian Federation is presented, which makes it possible to compare data for 9 years. The methods used: statistical, analytical. Results and discussion. In the process of studying the age structure of patients in day hospitals and in in-home health care in the Russian Federation for 2011-2019, the growth of the proportion of treated persons older than working age was determined: in day hospitals from 33,4 to 49,4%, in in-home health care – from 57,1 to 64,4%. For 9 years, the greatest increase was noted in the proportion of adult patients treated in day hospitals for neoplasms, diseases of the endocrine system, nutritional disorders and metabolic disorders; in in-home health care – for diseases of the nervous system, mental disorders and behavioral disorders; the proportion of children treated in day hospitals – for diseases of the nervous system, musculoskeletal system and connective tissues, in in-home health care – with respiratory diseases. The report documentation combines data on the performance of day hospitals and in-home health care of medical organizations providing outpatient care, which does not allow for their comparative analysis with previous years. Conclusions. In 2019, more than half of the patients treated in day hospitals and in in-home health care were older than working age. There are differences in the distribution of treated adults and children in day hospitals and in in-home health care. The main causes for treatment of adult patients in day hospitals were diseases of the circulatory system (34,4%), musculoskeletal system and connective tissue (12,9%), neoplasms (12,9%); in in-home health care – diseases of the circulatory system (65,4%), musculoskeletal system and connective tissues (11,8%); children in day hospitals – diseases of the nervous system (29,5%), respiratory organs (27,2%), digestion (12,4%), in in-home health care – diseases of the respiratory organs (90,5%). Supplements for inclusion in the reporting documentation concerning the activities of day hospitals and in-home health care of medical organizations that provide treatment on an outpatient basis are proposed.

A Study to Assess Home Health Nurses from a Carative Perspective

The aging population is steadily rising, resulting in an increased need for in-home healthcare. This study examined the impact of several carative factors demonstrated by home health nurses. Multiple regression was used to examine the impact of the carative factors, measured by the Caring Nurse Patient Interaction Scale (CNPI-70). A total of 77 home health nurses from five home health agencies in Northeastern Pennsylvania participated in the study. The findings indicate that the principles of care theory are widely applied in home health settings. The author recommends that care theory be a focus of educational health programs and future research.

Conflicts of Patient-Caregiver Communication and Some Workable Solutions

Health communication is a central topic in public health, especially due to the Affordable Care Act and subsequent changes in insurance policies which affect caregivers and healthcare systems. Poor communication skills in life leads to a myriad of issues, in healthcare it can lead to medical malpractice. This paper is a literature review based on the types of communication that takes place between doctors and their patients or healthcare-workers and their clients. It discusses a few common issues that arise in healthcare through an analysis of the distinct kinds of communication which takes place in many healthcare settings not partial to the hospital but includes nursing homes, the emergency room and in-home healthcare environments.

Designing an Intelligent In-Home Healthcare System

Due to the middle-aged population, the need for health services is increasing and more staff is required to visit and serve the homes of the elderly people. For many years, the shortage of specialized nurses and hard service programs has created a lot of pressure on health service centers and sometimes caused complaints of family members or elderly people. In order to have a good quality of these services, having an assessment strategy is required by determining the workload and staff personality of the nursing section. In this research, an in-home care institution was selected. Initially, a survey was conducted on elderly people and their families. Data was then managed using OLAP technology. One month after the implementation of the system, the survey was re-evaluated and then, using the Topics method, the nurses’ performance was ranked. The results showed that the satisfaction of the elderly people and their families from the in-home care institute has been promoted in all three dimensions of technical-vocational, training and trust, but there is still a degree of dissatisfaction.

Privacy-preserving voice-based search over mHealth data

Abstract Voice-enabled devices have a potential to significantly improve the healthcare systems as smart personal assistants. They usually come with a hands-free feature to add an extra level of usability and convenience to elderly, disabled people and patients. In this paper, we propose a privacy-preserving voice-based search scheme to enhance the privacy of in-home healthcare applications. We consider an application scenario where patients use the devices to communicate with their caregivers by recording and uploading their voices to the servers, where the caregivers can search the interested voices of their patients based on the voice content, mood, tone and background sounds. Our scheme preserves the richness and privacy of voice data and enables accurate and efficient voice-based search, while in current systems that use speech recognition, the richness and privacy of voice data are compromised. Specifically, our scheme achieves the privacy by employing a privacy-preserving voice feature matching technique and a novel category-based encryption; only encrypted voice data is uploaded to the server who is unable to access the original voice data. In addition, our scheme enables the server to selectively and accurately respond to caregivers' queries on the voice data based on voice similarities. We evaluate our scheme through real experiments and show that our scheme even with privacy preservation can successfully match similar voice data at an average accuracy of 80.8%.

Exploring caregiver burden within a veterinary setting

Veterinary RecordVolume 181, Issue 12 p. 318-319 Research Exploring caregiver burden within a veterinary setting Katherine J. Goldberg DVM, Corresponding Author Katherine J. Goldberg DVM kgoldberg@wholeanimalvet.com WholeAnimalVeterinary Geriatrics & Hospice...

Enhancing A Medbox for Health Precautions Using IOT

The ignorant nature and routine non-adherence towards medications have always caused immense imminence in terms of public health, also resulting in a significant amount of finance going run through. In-home healthcare services based on the Internet-of-Things (IoT) have great business potential; however, a comprehensive platform is still missing. This system shows how a Medbox can be used intellectually and effectively.

Exploiting IoT technologies for enhancing Health Smart Homes through patient identification and emotion recognition

Currently, there is an increasing number of patients that are treated in-home, mainly in countries such as Japan, USA and Europe. As well as this, the number of elderly people has increased significantly in the last 15 years and these people are often treated in-home and at times enter into a critical situation that may require help (e.g. when facing an accident, or becoming depressed). Advances in ubiquitous computing and the Internet of Things (IoT) have provided efficient and cheap equipments that include wireless communication and cameras, such as smartphones or embedded devices like Raspberry Pi. Embedded computing enables the deployment of Health Smart Homes (HSH) that can enhance in-home medical treatment. The use of camera and image processing on IoT is still an application that has not been fully explored in the literature, especially in the context of HSH. Although use of images has been widely exploited to address issues such as safety and surveillance in the house, they have been little employed to assist patients and/or elderly people as part of the home-care systems. In our view, these images can help nurses or caregivers to assist patients in need of timely help, and the implementation of this application can be extremely easy and cheap when aided by IoT technologies. This article discusses the use of patient images and emotional detection to assist patients and elderly people within an in-home healthcare context. We also discuss the existing literature and show that most of the studies in this area do not make use of images for the purpose of monitoring patients. In addition, there are few studies that take into account the patient’s emotional state, which is crucial for them to be able to recover from a disease. Finally, we outline our prototype which runs on multiple computing platforms and show results that demonstrate the feasibility of our approach.

Commentaries on health services research

Commentaries on health services research

Environmental Health and Safety Hazards Experienced by Home Health Care Providers: A Room-by-Room Analysis.

The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes.

The effectiveness of communication interventions in providing older people with information on access to in-home health and social care services: a systematic review protocol

The objective of this review is to locate, critically appraise and synthesize evidence on the effectiveness of communication strategies for providing older people access to information regarding in-home health and social care services. The review question is: What is the effectiveness of communication interventions in providing older people with information about in-home health and social care services?

The effectiveness of communication interventions in providing older people with information on access to in-home health and social care services: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The objective of this review is to locate, critically appraise and synthesize the evidence on the effectiveness of communication strategies for providing older people access to information regarding in-home health and social care services. The review question is: What is the effectiveness of communication interventions in providing older people with information about in-home health and social care services? INCLUSION CRITERIA Types of participants: This review will include studies that examine older people (50 years and over) who are seeking health and social care services information to enable them to remain in their own homes. The setting is community based and will exclude older people living institutionally. Types of interventions: This review will consider studies that evaluate communication interventions aimed at providing older people with access to health and social care services information and their ability to remain living independently for longer in their own homes. The intervention may include but not be limited to: the internet, mass media (broadcast and print, specialist and general), health professionals or expert advisers, organizations (government, not-for-profit, voluntary and commercial), personal social contacts (the “grapevine”), and publications and literature. Interventions may be compared against each other or compared to no intervention, as will be the usual care situation. Types of outcomes: As this review is considering the effectiveness of communication strategies for providing information to older people to enable maintenance of independence, the primary outcome will be satisfaction with strategies that assist them to access the services required. This will predominantly be measured byTRUNCATED AT 250 WORDS

Infrared Image Processing for a Physiological Information Telemetry System

Traditional measurements of physiological information are generally by contact mode. Although contact measurements have the advantage of high accuracy, some people feel uncomfortable, and the battery-operated portable or handheld measurement system cannot be implemented for long-term operation. In this work, we adopt a high performance infrared thermal imaging camera to scan and capture human body images. The grayscale image processing and conversion procedures are provided to detect human body temperatures and heart rates (HR). The remote monitoring measurement function for physiological information is suitable for in-home care, in-home care services, large hospitals or health care institutions. The system uses an infrared thermal imaging camera to search regions of the human body. The algorithm is applied to the elliptical model to search the human body for positions on the head and neck, which are captured because of the higher temperature regions on the neck. We use the fast Fourier transform method to transfer the temperature's data from the time domain into the frequency domain. Information from the human body temperature and HR are calculated using the correlation between heart rate and vessel temperature. This physiological information determines physical health symptoms and achieves the concept for a physiological information telemetry system.

A real-time life-care monitoring framework: WarnRed hardware and software design

It is shown by many statistical studies that the senior population, especially in developed countries, is in an increasing trend. For many reasons they tend to have in-home health care providers. The recent studies on biomedical information management focused on remote health monitoring frameworks including heart rate monitoring systems, glucose measurements for diabetics, and remote monitoring EEG and ECG. The main purposes of these studies are timely response to emergency situations and ensuring that the person is in a stable condition. In this study, developed via a system-on-chip circuit, we process the data collected from subjects through a temperature sensor and blood pressure sensor. Data are submitted in real time via a wireless secure channel to medical experts. An easy-to-use software interface is also developed as part of the framework.

A Novel Indoor Localization Algorithm Design for In-home Healthcare of the Elderly Based on WSN

A Novel Indoor Localization Algorithm Design for In-home Healthcare of the Elderly Based on WSN