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Toward Innovation in Healthcare Delivery in the Aged Society: Collaborative Visits by Hospital Specialist Nurses and Homecare Nurses
36 Pages Posted: 24 Jun 2020
More...Abstract
Background: Specialist nurses (SNs) attract a great deal of attention as professionals providing advanced care in homecare setting within aging societies. Recently in Japan, hospital SNs have begun to accompany homecare nurses to provide specialist care at home through collaborative visits. This study aimed to examine the current state of these collaborative visits and the associated factors.
Methods: We conducted a web-based cross-sectional questionnaire survey of all SNs (N=23,201) in Japan, and analyzed responses from SNs in specialties of wound, ostomy, and continence care (WOC), cancer palliative care, and care for chronic disease. Only WOC and cancer palliative care SNs are currently reimbursed for collaborative visits under national medical insurance. Multiple logistic regression analyses were used in each specialty to identify the associated factors.
Findings: Data from 1,027 eligible participants were analyzed. Collaborative visits were provided by 45·6% of SNs in WOC, 21·4% in cancer palliative care, and 18·3% in care for chronic disease. Among WOC and cancer palliative care SNs, collaborative visits were associated with the SN’s being in a managerial position (adjusted odds ratio 1·81, 95% confidence interval [1·07–3·07] and 2·62, [1·40–4·89], respectively) and the hospital’s being in a municipality with fewer hospital beds per capita and higher aging rate (0·92, [0·86–0·98] and 1·10, [1·02–1·18], respectively). Among care for chronic disease SNs, collaborative visits were associated with more work hours as a SN (2·16, [1·06–4·42]), less participation in community-based multidisciplinary gatherings (0·45, [0·21–0·97]), and hospital with open community consultation service (2·08, [1·01–4·27]).
Interpretation: SNs in each specialty conducted collaborative visits. As not only individual effort by SNs but also hospital attitude toward community seem important for collaborative visits, hospital-wide and policy-supported efforts may promote collaborative visits.
Funding: The Geriatric Health Promotion Project of the Ministry of Health, Labor, and Welfare, 2019
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: The University of Tokyo Graduate School of Medicine research ethics committee approved the study.
Keywords: Advanced practice nursing; Community integration; Delivery of health care; Health policy; Home care services; Nursing Care
Suggested Citation: Suggested Citation