Quality healthcare-in-the-home (HITH) services have been shown to improve outcomes for patients and their carers, as well as reduce costs and increase capacity for inpatient hospitals. However, barriers such as quality and safety concerns, lack of awareness, funding mechanisms, administrative burden and fluctuation in demand have led to resistance from health care professionals, meaning eligible patients are not being readily referred to HITH services.
The project itself aimed to identify these barriers and recommend efficient solutions that improve access to home healthcare.
AusHSI was engaged by Baxter to host an ideas forum at QUT. The forum aimed to address the challenges and benefits of enabling at-home care in the context of three services: hospital in the home, home dialysis, and home parenteral nutrition (HPN).
To inform debate on the day, AusHSI produced an Issues Paper, titled “Taking Healthcare Home”, which pulled together existing research and case studies comparing hospital treatment with acute and chronic treatment services in the home. Among its findings, the paper identified that treating acutely ill patients at home, rather than in hospital, could slash treatment costs by up to 50%, reduce mortality rates by 20%, make hospital stays shorter, and cut hospital readmission by a quarter.
Bringing together almost 100 leading clinicians, academics, policy makers, managers and carers AusHSI utilised a World Café approach with forum-goers – a flexible method for hosting group dialogues – to identify challenges in five key areas. These were funding accessibility, awareness, professional culture, poor engagement with technology, and support of patients and carers. Participants were able to discuss and give recommendations on how these challenges could be addressed in order to increase the uptake of HITH by health professionals, patients and carers.
As a result of the feedback from forum attendees, AusHSI launched a recommendations paper – Taking Healthcare Home Forum: Overview of findings and recommendations – which found home healthcare services in Queensland tend to be underfunded, outdated and poorly understood.
Based on their findings, AusHSI has recommended a number of practical, insightful ways to improve access to quality at-home care. If followed through, these recommendations will create a professional culture that is familiar with and confident in HITH as a viable alternative to inpatient care.