The number of people over the age of 60 is expected to at least double by 2050, with the over-80 population projected to grow at an even faster rate in many countries. To keep national health care spending down, countries will need to figure out ways to support and encourage care that is delivered in the home, the lowest-cost and oft-preferred setting for older adults.
A team of international researchers set out to evaluate the current and future global landscape for home-based care as part of a new study published in Nurse Education Today.
“There’s a growing need to care for the world’s aging population,” Olga Jarrín, an assistant professor at the Rutgers School of Nursing and lead author of the study, told Home Health Care News. “In order to do that successfully and in a way that is cost-effective, the expansion of home care and home-based care needs to be supported.”
As part of the study, which featured feedback from nursing veterans from more than a dozen countries, researchers identified four major, cross-cutting themes linked to that support. Broadly, those themes include the needs to redesign countries’ health systems to prioritize home care, to adopt evidence-based guidelines, to develop home care leaders at all levels and to address payment issues that create barriers to care.
Even in countries known for having relatively strong health care systems, home- and community-based care delivery could be strengthened further, according to Jarrín.
“This had been something that the International Home Care Nurses Organization had been wanting to do — get some international consensus around prioritize around the future of home care education, practice and management,” she said.
Individuals who provided feedback for the study all had home care nursing experience, with an average of 29 years in nursing and 17 years in home care. Participants self-identified from 17 countries in total — from Brazil and Chile to Iceland, India, Jordan and others.
While tackling issues such as payment reform and policy can be challenging, there are some seemingly simple measures that health care stakeholders can take to boost home care’s place globally. Researchers recommended, for instance, a need for educators to highlight home care’s role to students early in their respective curriculums.
Currently, especially in toward the beginning, nursing curriculums typically focus on hospital and acute-care settings.
“Many people in the community — and students when they begin nursing school — they think about nurses as working in hospitals,” Jarrín said. “For nursing students to have greater exposure to positive experiences in the community and in-home care is a big way to improve health care for older adults. It’s important to find ways to make nursing students interested in home care as a career and help them understand the types of care patients can receive when they leave the hospital.”
The state of home care is currently being explored by the 2019 World Economic Forum System Initiative on Shaping the Future of Health and Healthcare.
The global population of the “oldest old” — people aged 80 and older — is expected to more than triple between 2015 and 2050, growing from 126.5 million to 446.6 million. The oldest old population in some Asian and Latin American countries is predicted to quadruple by 2050.
Funding for the study was supported, in part, by the Agency for Healthcare Research and Quality.