Home Care
Due to its well developed home care system, Sweden has just two inpatient beds per 1,000 inhabitants. This is the lowest among developed countries and is the result of a strategic shift towards more patient-centric care. Not only is patient-centric care often more cost-efficient, but studies show that patients prefer it as it is less disruptive to their normal life.
There are two greater factors driving the shift
- Better patient outcomes (often significantly better).
- Skilled clinical staff are in scarce supply, and many leave the profession out of frustration that the old system failed to structure the empathy that attracted them to the profession in the first place. In patient-centric home care, the patient becomes a person again, thus increasing job satisfaction among clinical staff and greater staff retention. Furthermore, as the patient is more involved in the care process, fewer staff hours are often needed, compared to traditional inpatient care.
Home care is not limited to the elderly. As a more holistic view on patients’ needs emerges – regardless of age – inpatients are increasingly offered the opportunity to receive a suitable level of support at home, instead of remaining in hospital.
There are several levels of care, from the daily care of elderly to “Hospital at Home” and “Advanced Hospital at Home” including palliative care.
Care and support take place in close collaboration with other caregivers such as social care, primary care, private network, family, in-care personnel, employer, school and others.
Benefits include
- Patient-centered needs better met
- Interprofessional / horizontal approach
- Home care can improve sleep and eating habits
- More active patients in a familiar environment
- Patients feel safer with regular home visits
- Patients feel more independent and empowered
- Avoid the stress of transport and hospitalization
The term “Close Care” entails significant shifts in health care ambitions
- From reactive – to proactive
- From patients passively receiving care – to actively co-creating care
- From focus on organization – to focus on the individual and relationships
- From Isolated care events – to coordinated patient-centric care
Psychiatry is an example of a radical shift from traditional inpatient services to home care in Sweden. Today there are very few inpatients – mainly for acute events – as home care shows much improved results. In addition to “normal” home care teams there are wider FACT teams (Flexible Assertive Community Treatment). They assist the psychiatric patient in a wider sense, such as in collaboration with social care, primary care, private network, employer, school, and others.
Reduced avoidable admissions: When introducing mobile teams for elderly care in the city of Malmö a 17% decrease in avoidable admissions to hospital was achieved. As well as saving money, it is also better for the patient as they remain much more active at home than they would be as a hospital inpatient. The patient not only feels safer at home, but it enables a better balance of power towards the caregiver.
To monitor quality of outcomes there are several National Quality Registries to follow key parameters / KPIs e.g. Swedish Palliative Care Registry.
Want to know more about Swedish experiences in patient centric home care?
