Access to home care for elderly varies widely

A REPORT analysing the value of home care packages (HCP) in assisting elderly people to remain at home has found access to packages varies widely depending on where you live.

The Evaluation of Home Care Packages report, by the PA consulting group, also found the content of the type of package available varies around the country, with some offering a wider range of services.

The report found:

* The average weekly cost of a HCP ranges from €128.99 (Donegal) to €497.40 (Galway), with an average of €318.99 across the eight local health offices surveyed.

* In 2008, there were 4,161 recipients in Dublin North-East compared with 2,467 in HSE South. The variance was not due to population size or age profile. For every 1,000 people over 65 in Dublin North-East there were 45 HCP recipients in 2008, compared with 19 in HSE South.

* The variance is wider at local health office level (LHO). For example, for every 1,000 people over 65 in Meath there were 52 HCP recipients in 2008, compared with eight in Wicklow.

The report said factors causing this variance included whether the HCP was of long or short duration and of high or low value (less services).

The report said the inconsistent approach to delivery of HCPs was “a symptom of the lack of a national approach” by the Health Service Executive (HSE).

It said not enough progress had been made in using the HCP as a tool to prevent acute hospital admissions. It also said the nationally available financial data on how the HCP budget is allocated and spent is “extremely limited”, and “does not facilitate full analysis or monitoring of HCP costs, budget or spend on an ongoing basis”.

The report makes 20 recommendations including the establishing of robust financial monitoring of the HCP budget and a full value for money assessment once delivery is standardised.

On a positive note, it said the Health Service Executive had achieved good progress against the HCP objectives and was “facilitating timely discharge for older people, supporting carers to continue to care and enabling older people to live at home for longer”.

Improvements to quality of life for clients were specifically identified in 27% of files surveyed by the report’s authors. However dependency levels worsened for 38% of recipients surveyed.


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