Renee D Boss1,2, Jessica C Raisanen2, Kathryn Detwiler3, Karen Fratantoni4, Susan M Huff5, Kathryn Neubauer1,2, Pamela K Donohue1,6. 1. Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA. 3. Childrens National Medical Center, Washington, DC, USA. 4. Children's National Health System, Washington, DC, USA. 5. Johns Hopkins Home Health Group, Baltimore, MD, USA. 6. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
Background. For children with complex medical conditions, pediatric home health care is a chronic need. It is a clinical service delivered entirely outside of clinical settings, granting families unparalleled expertise regarding service quality. Methods. Telephone interviews with parents whose children have extensive experiences with home health care. Results: Five themes emerged: (1) benefits of home health care include child survival and family stability; (2) family life is inextricable from home health care schedules, staffing, and services; (3) home health care gaps threaten family physical, mental, and financial well-being; (4) Out-of-pocket costs are common; and (5) families must fight for services as their children's medical conditions evolve. Conclusions. Families understand better than prescribers, providers, or policy makers what is working, and what is not, with home health care. Family expertise should be the foundation for training other families, clinicians, and home health care agencies, and should be a central component of policy and advocacy in this area.
Background. For children with complex medical conditions, pediatric home health care is a chronic need. It is a clinical service delivered entirely outside of clinical settings, granting families unparalleled expertise regarding service quality. Methods. Telephone interviews with parents whose children have extensive experiences with home health care. Results: Five themes emerged: (1) benefits of home health care include child survival and family stability; (2) family life is inextricable from home health care schedules, staffing, and services; (3) home health care gaps threaten family physical, mental, and financial well-being; (4) Out-of-pocket costs are common; and (5) families must fight for services as their children's medical conditions evolve. Conclusions. Families understand better than prescribers, providers, or policy makers what is working, and what is not, with home health care. Family expertise should be the foundation for training other families, clinicians, and home health care agencies, and should be a central component of policy and advocacy in this area.
Entities:
Keywords:
Medical complexity; family experience; home health care
Authors: Rose Y Hardy; Gilbert C Liu; Kimberly J Conkol; Sean P Gleeson; Kelly J Kelleher Journal: J Rural Health Date: 2021-05-12 Impact factor: 5.667