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Accessibility, utilisation and acceptability of a county-based home care service for sick children in Sweden

Castor, Charlotte LU ; Hallström, Inger Kristensson LU ; Landgren, Kajsa LU and Hansson, Helena LU (2019) In Scandinavian Journal of Caring Sciences 33(4). p.824-832
Abstract

Background: Home care service (HCS) for sick children is a complex healthcare service, which can be organised in various models. Despite the possibility to support family everyday life, the accessibility and utilisation may still be limited. The aim of this study was to (i) determine characteristics in referrals to county-based HCS, (ii) determine characteristics of referred children and (iii) assess acceptability of parents and children in county-based HCS. Methods: Data on characteristics of referrals and referred children were collected from medical records of children 0–17 years of age, referred to eight HCS units during 2015–2018. Data on parental and child overall experience, satisfaction of, safety with, and preference for care,... (More)

Background: Home care service (HCS) for sick children is a complex healthcare service, which can be organised in various models. Despite the possibility to support family everyday life, the accessibility and utilisation may still be limited. The aim of this study was to (i) determine characteristics in referrals to county-based HCS, (ii) determine characteristics of referred children and (iii) assess acceptability of parents and children in county-based HCS. Methods: Data on characteristics of referrals and referred children were collected from medical records of children 0–17 years of age, referred to eight HCS units during 2015–2018. Data on parental and child overall experience, satisfaction of, safety with, and preference for care, were collected from parents by a questionnaire. Descriptive and comparative statistics were used to analyse the data. Results: Three hundred and fifty-five referrals led to one or more periods of HCS for 171 children in various ages with a wide range of illnesses. Children with cancer (30%) composed the largest group and administration of intravenous antibiotics accounted for 56% of the care tasks. Seven per cent of the referrals were to palliative home care. Thirty-eight referrals of 34 children were refused. There was an uneven distribution of the indication for referral, acceptance rate and diagnoses of children among HCS units. Parents reported their and their child's experience with the HCS visit as highly positive and preferred home care to hospital care in over 96% of the HCS in 212 visits. Conclusion: County-based HCS constitutes a supplement to hospital care for sick children with various illnesses through different stages of acute and long-term illness and at end of life, with high levels of acceptability. Few referrals and variation in referral characteristics and acceptance rate of referrals between HCS units led to unequal and inequitable accessibility and utilisation of HCS.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
home care service, paediatric, preference for care, referral, satisfaction with care, utilisation
in
Scandinavian Journal of Caring Sciences
volume
33
issue
4
pages
824 - 832
publisher
Wiley-Blackwell
external identifiers
  • scopus:85062999110
  • pmid:30865330
ISSN
0283-9318
DOI
10.1111/scs.12678
project
Children with cancer
LUC3 - Lund University Child Centered Care
Hospital-based Home Care for children with long-term illness
language
English
LU publication?
yes
id
fbb97f14-397b-4491-883a-23ce1eca068c
date added to LUP
2019-03-29 09:46:26
date last changed
2021-01-19 02:37:17
@article{fbb97f14-397b-4491-883a-23ce1eca068c,
  abstract     = {<p>Background: Home care service (HCS) for sick children is a complex healthcare service, which can be organised in various models. Despite the possibility to support family everyday life, the accessibility and utilisation may still be limited. The aim of this study was to (i) determine characteristics in referrals to county-based HCS, (ii) determine characteristics of referred children and (iii) assess acceptability of parents and children in county-based HCS. Methods: Data on characteristics of referrals and referred children were collected from medical records of children 0–17 years of age, referred to eight HCS units during 2015–2018. Data on parental and child overall experience, satisfaction of, safety with, and preference for care, were collected from parents by a questionnaire. Descriptive and comparative statistics were used to analyse the data. Results: Three hundred and fifty-five referrals led to one or more periods of HCS for 171 children in various ages with a wide range of illnesses. Children with cancer (30%) composed the largest group and administration of intravenous antibiotics accounted for 56% of the care tasks. Seven per cent of the referrals were to palliative home care. Thirty-eight referrals of 34 children were refused. There was an uneven distribution of the indication for referral, acceptance rate and diagnoses of children among HCS units. Parents reported their and their child's experience with the HCS visit as highly positive and preferred home care to hospital care in over 96% of the HCS in 212 visits. Conclusion: County-based HCS constitutes a supplement to hospital care for sick children with various illnesses through different stages of acute and long-term illness and at end of life, with high levels of acceptability. Few referrals and variation in referral characteristics and acceptance rate of referrals between HCS units led to unequal and inequitable accessibility and utilisation of HCS.</p>},
  author       = {Castor, Charlotte and Hallström, Inger Kristensson and Landgren, Kajsa and Hansson, Helena},
  issn         = {0283-9318},
  language     = {eng},
  month        = {03},
  number       = {4},
  pages        = {824--832},
  publisher    = {Wiley-Blackwell},
  series       = {Scandinavian Journal of Caring Sciences},
  title        = {Accessibility, utilisation and acceptability of a county-based home care service for sick children in Sweden},
  url          = {http://dx.doi.org/10.1111/scs.12678},
  doi          = {10.1111/scs.12678},
  volume       = {33},
  year         = {2019},
}