It is not uncommon to devote a lot of time to terminological discussions related to the low acceptance of the term home hospitalization among primary care professionals. Naturally, the words are not neutral, but the description of the intervention patterns at home could be an excellent mechanism to identify the devices with the capacity to give the best possible assistance response.
In the definition of the patterns of care that can be provided at home, and that requires a certain degree of continuity, these significant aspects can be considered:
- Duration Of Care
A short duration (of about 15 days) allows an incredible intervention intensity if the length of the care is long (up to 60 days) or indefinite.
The complexity is not easy to define, but the need for devices (a ventilator, food infusion pumps, among others), the importance of decision making (e.g., deciding a tracheotomy in a patient with a neuromuscular disease) ) or the magnitude of the aids needed to carry out activities of daily living will determine many aspects of the intervention pattern.
The number of daily visits required also determines the intervention pattern. It is unlikely that a primary care team can make regular visits for about 15 days, systematically and routinely.
- Speed Of Response
The response must be faster, the higher the patient’s acute situation or, the greater the fragility of the patient.
- Definition Of Intervention Patterns
With these four variables, and considering the set of resources of the environment where home care should be developed, we can define some intervention patterns.
- Long-Term Home Care
In long-term home care, patients who can not go to the health center are attended to at home. It usually occurs indefinitely, with a small intensity of visits, having to face a low complexity and a response speed that can be low, since a large part of the holidays is programmable.
- Home Care For Acute Patients That Replaces The Hospital
Home care capable of replacing admission should be able to provide a rapid response if you want to guarantee the availability of beds for other acute patients. Thus, the pattern of intervention, in this case, is characterized by a short duration (such as hospital admission), with little technical complexity, high intensity of visits (at least one tour by a nursing graduate once a day) and speed of very high response. Thehome care nurse services[jasaperawat, which is the term in Indonesian] have the capacity to assess the patient in the hospital and visit it at home a few hours after discharge, if necessary.This hospital replacement scheme has been proposed to patients with chronic diseases exacerbated to avoid admission or shorten stays, or surgical patients in which early discharge is submitted.