An historical perspective on home care policy

Area of Science:

• Health services research
• History of medicine
• Public health policy

Background:

• Home care has gained policy attention but lacks historical perspective in health services literature.
• The perception and support for home care have evolved significantly over time.
• Modern medicine has influenced the role of home care, often positioning it as a secondary service.

Observation:

• A historical analysis reveals both changes and continuities in home care.
• The legitimacy of home care has historically relied on its potential to reduce institutional care costs and utilization.
• Lack of consensus on home care's objectives has persisted.
• Demographic shifts and fiscal pressures have heightened demand for home care, particularly for chronically ill patients.

Findings:

• Home care's policy relevance has been paradoxically maintained and undermined by cost-saving claims.
• Despite increased demand, fundamental issues regarding home care's role and goals remain unresolved.
• The historical trajectory of home care demonstrates a complex interplay between policy, medical advancements, and societal needs.

Implications:

• Understanding the history of home care is crucial for addressing current policy challenges.
• Future policy must reconcile the demand for home care with unresolved issues of its goals and integration into the broader health system.
• Further research is needed to establish a clear and sustainable framework for home care services.