Bringing healthcare home

Home healthcare systems combine medical and social services to allow a frail person as much independence as possible. Such systems are concerned with maintaining family unity and preserving wellness (rather than merely treating sickness). With improved reimbursement policies, home health agencies could provide effective case management and screening mechanisms to prevent unnecessary institutionalization. Providers must be multidisciplinary specialists, and, unlike acute care providers, they must approach the client from the position of a guest in the home. Establishing rapport and a cooperative relationship with the family is critical to the provision of home care. Formal quality assurance programs focusing on structure, process, and outcomes of home care are essential to maintain high quality. Such programs will not be inexpensive, but they can provide high-quality, cost-effective care.