Evaluating the introduction of Positive Health on the amount of received home care nursing to older patients: a pre-post study

Abstract

Background: As older people continue to live at home longer, the demand for home care nursing increases. In terms of Positive Health (PH), home care focuses on strengthening the self-reliance and -management of the patient. Currently, there is a lack of evidence on the impact of the introduction of PH on health care consumption within a home care setting. Aim: To assess the influence of the introduction of PH on the average amount of received home care nursing in minutes per week to home care patients over a period of six weeks. Method: A pretest-posttest study was performed to compare the amount of home care in minutes per week over a period of six weeks. Two random samples were extracted from the Electronic Health Record within a health care organization in the Netherlands. Data of patients receiving home care pre-introduction of PH (2018) was compared to patients receiving home care post-introduction of PH (2020). Routinely collected health data was used and compared using a Mann-Whitney U test. Results: In total, 352 patients, 176 patients per group, were included. Univariate analysis showed a significant difference in the received amount of home care (p=0.005). The median was significantly lower in the PH group (176.25, IQR=111.7-287.9) compared to the no-PH group (180.67, IQR=83.8-248.7). In addition, significant difference were observed in type and number of nursing diagnoses. Conclusion and recommendation: Patients in PH group received a lower amount of home care compared to patients in the no-PH group. In addition, a lower number and type of nursing diagnoses were observed by home care patients in the PH group compared to the no-PH group. Keeping home care affordable, more research focused on the actual effects of PH in daily practice is needed, to be of value of the increasing demands of home care worldwide.