Evaluation of Home Healthcare Services by Service Providers and Users

Background: Turkish Ministry of Health transferred the delivery and coordination of home healthcare services from primary health care institutions to hospitals on 15 May 2017.
Objective: In this research, it is aimed to determine the opinions of the staff who provide home healthcare services and the patients and their relatives who receive service regarding this organizational change made during the service delivery process.
Design: For this purpose, qualitative and quantitative research methods were used in the study conducted in Ankara and Eskişehir provinces.
Setting(s): The study was conducted in Ankara and Eskişehir provinces in Turkey.
Participants: The questionnaire, which was prepared based on the qualitative research findings, was applied to a total of 396 people, including 74 health personnel and 322 patients or their relatives, in the quantitative research.
Methods: While the validity of the questionnaire used was evaluated with exploratory and confirmatory factor analyzes and its reliability with the Cronbach alpha coefficient, the hypothesis was tested with the t test.
Results: After the organizational change in the home healthcare services, it was observed that patients and their relatives gave a more positive opinion than the healthcare personnel on the issues that patients were visited more frequently and their satisfaction levels increased, the health status of the patients was monitored more, and those in real need benefit more from home healthcare services. Furthermore, it was observed that patients and their relatives gave more positive opinions than healthcare personnel about the need for more socio-economic support to patients and their relatives within the scope of home healthcare services. On the other hand, it was observed that the healthcare personnel gave more positive opinions than the patients or their relatives that the patients had easier access to diagnosis services, the number of personnel, personal rights and security services should be improved. In addition, it has been observed that the health personnel gave a more positive opinion than the patients or their relatives about the provision of home healthcare services by the private sector.
Conclusions: After the delivery and coordination of home health services was transferred from primary health care institutions to hospitals, it was found that patients/patient relatives participated more in visit frequency-satisfaction, monitoring-evaluation, equity and socio-economic support dimensions than health personnel. On the other hand, it has been found that healthcare personnel participate more in the dimensions of access to service, personnel-financial support and private sector-security support than patients/patient relatives.