Factors associated with homecare coordination and quality of care : a research protocol for a national multi-center cross-sectional study

Möckli, Nathalie (Department of Public Health, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland) ; Simon, Michael (Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland ; Nursing Research Unit, Inselspital Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland) ; Meyer-Massetti, Carla (Department of Pharmaceutical Sciences, Clinical Pharmacy & Epidemiology, c/o University Hospital Basel, Spitalstrasse 26, CH-4031, Basel, Switzerland ; Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, CH-3012, Bern, Switzerland) ; Pihet, Sandrine (School of Health Sciences, HES-SO Fribourg) ; Fischer, Roland (Centre for Primary Health Care, University of Basel, Rheinstrasse 26, CH-4410, Liestal, Switzerland) ; Wächter, Matthias (Institute for Business and Regional Economics IBR, Lucerne University, Zentralstrasse 9, CH-6002, Luzern, Switzerland) ; Serdaly, Christine (serdaly&ankers snc, Route de Florissant 210, CH-1231, Conches, Switzerland) ; Zúñiga, Franziska (Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland)

Introduction The persistent fragmentation of home healthcare reflects inadequate coordination between care providers. Still, while factors at the system (e.g., regulations) and organisational (e.g., work environment) levels crucially influence homecare organisation, coordination and ultimately quality, knowledge of these factors and their relationships in homecare settings remains limited. Objectives This study has three aims: [1] to explore how system-level regulations lead to disparities between homecare agencies’ structures, processes and work environments; [2] to explore how system- and organisation-level factors affect agency-level homecare coordination; and [3] to explore how agency-level care coordination is related to patient-level quality of care. Design and methods This study focuses on a national multi-center cross-sectional survey in Swiss homecare settings. It will target 100 homecare agencies, their employees and clients for recruitment, with data collection period planned from January to June 2021. We will assess regulations and financing mechanisms (via public records), agency characteristics (via agency questionnaire data) and homecare employees’ working environments and coordination activities, as well as staff- and patient-level perceptions of coordination and quality of care (via questionnaires for homecare employees, clients and informal caregivers). All collected data will be subjected to descriptive and multi-level analyses. Discussion The first results are expected by December 2021. Knowledge of factors linked to quality of care is essential to plan and implement quality improvement strategies. This study will help to identify modifiable factors at multiple health system levels that might serve as access points to improve coordination and quality of care.

Article Type:
Recherche appliquée et développement Santé HEDS-FR
14 p.
Published in:
BMC Health Services Research
Numeration (vol. no.):
2021, no. 21, 306
Appears in Collection:

 Record created 2021-04-30, last modified 2021-04-30

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