Benefits of Home-Based Services in Greece for the Homebound: Leveraging Insights and Perspectives from Primary Healthcare Professionals

Dimitra Iosifina Papageorgiou, Despoina Symintiridou, Marilena Gialama, Stella Ploukou, Martha Andreou, Ilias Theodoropoulos, Stavroula Begou, Panagiotis Stachteas, Ilias Pagkozidis, Chrysovalantis Kakanis, Magda Gavana, Emmanouil Smyrnakis

Keywords: Homebound; Primary Healthcare services; Home-based primary care; Homecare; healthcare needs

Background:

Home-based primary care services are beneficial to those experiencing challenges in accessing healthcare services and the implementation of such programs can improve population health and address access inequalities for vulnerable populations such as the elderly.

Research questions:

What benefits do home-based primary care services offer for homebound populations, according to primary healthcare professionals with previous experience in the delivery of home care services?

Method:

This is a qualitative study, conducted from February to May 2022, part of a larger project on the development of a sustainable home-based primary care service in Greece. Purposeful sampling with maximum variation (primary healthcare professionals, public/private sector, urban/ rural/ island setting, participation in covid-19 home vaccination programme/ other home care experience) was used. Semi-structured interviews were conducted using an interview guide focused on the advantages of home-based primary care services, the obstacles and enabling factors and recommendations for implementing home-based primary care services. Participants were particularly asked to discuss the benefits of home-based primary care services for the patient, their families, and healthcare professionals. Audio files were transcribed verbatim, coded and thematic analysis was performed. Informed written consent was obtained from participants.

Results:

After 43 interviews, data saturation was reached. Five key themes emerged: service users empowerment, relationships' strengthening, healthcare professional and challenges, and system improvements. Patients gain from better care, self-care education, and support. Informal caregivers benefit from more time, education opportunities, and support. Relationships among patients, caregivers, and healthcare professionals improve, and families save on transportation costs. Healthcare professionals find empowerment through self-accomplishment and professional growth opportunities, despite challenges like external conditions, psychological burden, and organizational problems. Healthcare system advantages include reduced care costs, increased trust, and more job opportunities.

Conclusions:

Extending primary care to the home setting could provide multiple advantages, to both service users and the entire healthcare system increasing satisfaction and the quality of life.

Points for discussion:

What are the primary obstacles hindering the implementation of home healthcare services within health systems?

How could participatory research approaches accelerate the creation of cost-effective, comprehensive home-based healthcare services?

What strategies can be implemented to promote and expand home-based primary care services?

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