Sunday, December 12, 2010

Study on Home Health Care

Using home healthcare technologies may provide a solution on how to sustain global healthcare systems threatened by rising costs and personnel shortages. However, changes will be required to treat patients and will probably face multiple obstacles to adoption, according to a new RAND Corporation study “Health and Well-Being in the Home: A Global Analysis of Needs, Expectations, and Priorities for Home health Care Technology.”

The study finds that a wide array of healthcare stakeholders agree that expanding home-based health tools could give patients a greater ability to self-manage their conditions in partnership with their medical providers and help to improve their health and overall well-being.

However, moving care to patients’ homes would be a major shift in the structure of healthcare and can only be accomplished if consensus is reached between patients, healthcare providers, insurance companies, and policy makers, according to the report.

The study’s findings are from a global study of the needs, expectations, and priorities regarding home healthcare among key stakeholders in China, France, Germany, Singapore, the United Kingdom, and the U.S. Researchers conducted interviews with government officials, regulators, providers, insurers, manufacturers, distributors, and patient organizations, as well as reviewing existing research on home healthcare.

In the U.S., people age 64 and older account for 12 percent of the population, yet incur 34 percent of the nation’s total healthcare spending. While this trend started in the developed world, it is increasingly affecting developing and transitional nations. For example, Singapore has become the world’s most rapidly aging country and already 80 percent of all deaths in China are caused by chronic diseases.

“The aging of the world’s population and the fact than more diseases are treatable will create serious financial and personnel challenges for the world’s healthcare systems, said Dr. Soeren Mattke, the study’s lead author and a senior natural scientist at RAND, a non-profit research organization.

Home healthcare technology spans a broad spectrum from basic diagnostic tools, such as glucose meters, to advanced telemedicine solutions. These advances have pushed the frontier of care management further into the home setting.

While there are signs that home healthcare is increasingly on the radar of policy makers in many countries, researchers say that both the policy environment and the products themselves must be redesigned to realize the potential benefits.

Manufacturers will need to develop affordable products with intuitive designs to meet patient needs, provide ongoing support for patients and their families, and help integrate the services and data provided by other professional care providers.

However, these technologies face a number of barriers to adoption. For example, restrictive insurance coverage and existing incentives for in-person home care creates obstacles, and limited patient readiness because of insufficient health literacy according to the study. Additionally, concerns about audience appropriate product design and support plus limited information on whether the technology is effective and efficient also poses barriers to adoption.

Companies must also provide evidence for the clinical and cost effectiveness of home care products, while healthcare providers will need to embrace a new role as partners to their patients in the care process, rather than acting as paternalistic caregivers according to researchers.

Policymakers will have to develop a vision for the appropriate role of home healthcare and drive the agency to implement that vision. In order to proceed, the healthcare system needs to align the payment system and incentives with policy goals, clarify the regulatory framework for home healthcare technology, and promote receptiveness for the new models of care delivery.

The study was supported by Royal Philips Electronics and is available at