Nursing Home Care: Services, Impact, Effectiveness, Efficiency, and Equity

This presentation discusses nursing home care in Australia, including its services, impact on the ageing population, effectiveness, efficiency, and equity. It also provides recommendations for improving the quality of service offered in nursing homes.

NURSING HOME CARE
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Introduction
 A nursing home is a high-quality institution that is
highly regulated for the care as well as treatment of
the older population.
 These people have physical health issues, mental
complications or cannot get care at home.
 Changes in the Australian nursing homes have been
attributed to government regulations as well as
consumer pressures among other factors.

Description of Service and impact on
Australia's ageing Population
 Nursing home care is a combination of different services that are
offered at a nursing home.
 This care involves a comprehensive scope of medical, social and
personal services which are coordinated to meet the physical,
emotional as well as the social needs or people that are either
chronically ill, disabled or lack proper care at home (WebMD, 2018).
 Characteristics of nursing home care include:
1. it is meant for the elderly.
2. involves a wide array of other services which focus on the on the
physical, social and emotional needs of their patients
3. personal care is also offered such as bathing, dressing as well as
toilet assistance, and Room and Boarding are offered.

Description of Service and
impact on Australia's ageing
Population Cont. The provision of these types of services has had a significant impact
on the aging population of Australia.
 Over the years, the government has strived to ensure that these
services are kept to a certain standard and that it is affordable for the
citizens.
 The government endeavors to improve the quality of services in
nursing homes have seen more people to be committed to these
facilities.
However, this has not come without challenges. According to Wynne
(2006), some home care businesses have been accused of engaging in
fraudulent activities, extorting the elderly and their families for
services and medication that are not necessary.

Effectiveness of Nursing Home Care
i) Clinical Effectiveness
 Serious concerns have persisted over the quality of services offered to
individual patients in nursing home care.
 In some areas, however, the quality of care in nursing homes might have
improved even though the facilities are now serving a sicker population
(Stadnyk et al., 2011).
 It is the duty of the health care providers at these facilities to ensure that
the elderly do take their medication at the right time and that this process is
not skipped as it is geared towards maintaining their well-being health wise.
 The physical services such as bathing, dressing as well as toilet assistance
are implemented in the nursing care and therefore provide excellent
attention to the patients.

Effectiveness of Nursing Home
Care Cont.
i) Clinical Effectiveness cont.
 Apart from medical services, there are additional services that are
offered such as physical and social services.
The physical services such as bathing, dressing as well as toilet
assistance are implemented in the nursing care and therefore provide
excellent attention to the patients.
social services ensure that the nursing homes do not only create a
sense of a medical facility but rather a retirement home for the
elderly where they can engage in various activities during their stay
and therefore making this service quite effective.

Effectiveness of Nursing Home
Care Cont.
• ii) Population Effectiveness
 Nursing home care can also be channeled toward improving the
health of populations via medical or non-medical services
 In Australia, many elderlies are now opting for home-based care
rather than nursing home cares.
 home-based care has proven effective since the practitioners have
been in a position to help the population through the elderly when
they visit their homes either through medical or non-medical services.

Efficiency of Nursing Home Care
I. Production Efficiency (Clinical Perspective)
 It is commonly believed that the inefficiencies that are occurring in a
nursing home and healthcare facilities are mainly contributed by the
dramatic increase in the cost of healthcare in the recent years.
 Nursing homes in Australia have had a great deal of expenditure that
approaches 1% of the Gross National Product (GNP) and thus
represent an important industry.
 For this reason, many people are shying away from accessing these
services for the financial burden on them and prefer care at home.
However, since the government has devoted special funds for the
elderly in Australia, now more people can afford the care than before.

Efficiency of Nursing Home Care
Cont.
I. Production Efficiency (Clinical Perspective) cont.
When funds are provided, the quality of service offered in a nursing
home is set to rise as resources for the improvements can now be
acquired.
 This is of particular importance since government reforms have
made it possible for more people to afford the care services and for
the facilities to improve the quality of their service by ensuring the
staff is sufficiently competent to handle patients (Clauser & Harris,
2002, p.9). Doing this ensures that facilities adhere to strict law
structures.

Efficiency of Nursing Home Care cont.
ii. Production Efficiency (Population Perspective)
 While the consumers are demanding for a more flexible way of providing
nursing home care services, structural reforms have resulted in the health
providers adopting new methods of operating.
 The federal government of Australia at one point found out the extortion
that was happening in nursing home facilities and thus discovered that
the population was losing a lot of money for inferior services.
 For this reason, to ensure that the community gets the value for their
monies and that they do not pay more than what they are supposed to
pay, the government amended the laws to ensure that the funds that
were provided to the facilities from the government were cut.

Efficiency of Nursing Home Care
cont.
ii. Production Efficiency (Population Perspective)
 when the government found out about the allegation against these
facilities, the money was instead given out to individuals in the society
who were in need of the health services making it easy to prevent
extortion by the facilities.
 This move has proved to be efficient in the provision of better
healthcare since now more people can afford nursing homes and
when they pay, their money is specifically geared towards ensuring
that the needs of the elderly are met.

Efficiency of Nursing Home Care
cont.
iii) Allocation Efficiency (Population Perspective)
 In Australia, the government has been crucial in the corporatization
of aged care, and therefore the story of allocation efficiency cannot
be told without analyzing the role of the government.
 In the U.S, it was the financiers as well as businessmen that have
driven the marketization of such welfare services for the aged
population.
 In addition to this, their government has offered their support,
influence, and credibility to a great extent.

Efficiency of Nursing Home Care
cont.
iii) Allocation Efficiency (Population Perspective) cont.
In Australia, the public backlash was a significant setback that
frightened this particular market.
 For that reason, the government had to maintain to be the primary
allocator of funds for these facilities.
When the funds were allocated to the facilities, another setback was
experienced in that the centers started using the funds
inappropriately and therefore reforms had to be made where the
money would go to individual patients to avoid the vice (National
Academy of Science, 2001. P. 6).

Equity in Nursing Home Care
I) Procedural Equity (Clinical Perspective)
 To distribute fair services among individuals, it is essential that the
healthcare providers in a nursing home are competent and have been
trained towards ensuring equity in the delivery of services to the
elderly.
 In nursing home care, professional standards must be maintained at
all times which involves procedural equity.
 Over the decades, there has been research on the patient's reactions
towards the healthcare providers and how satisfied they are with the
services offered.

Equity in Nursing Home Care
cont.
ii) Substantive Equity (Clinical Perspective)
 There could be disparities concerning equal distribution of health
care among individuals.
 These disparities create a state of poor healthcare which is not the
focus on many facilities in Australia.
To ensure that there are no disparities in the distribution of such
services among individuals, policies have been established which
clearly outline that equity should prevail when delivering services.

Equity in Nursing Home Care
cont.
• iii) Procedural Equity (Population Perspective)
 In some instances, health services that are distributed are not
provided fairly among specific populations for various reasons.
 Nursing homes tend to of different classes, and each class has their
rate.
To ensure that there everyone is treated fairly, the healthcare
providers must ensure that they include procedural equity in their
way of doing things (Frogner et al., 2005 p. 10).

Equity in Nursing Home Care
cont.
iv) Substantive Equity (Population Perspective)
 In some areas, it is possible to find that the services that are
provided are not offered to all people in a similar fashion depending
on the region that a person comes from.
 Various factors could contribute to the disparities in the distribution
of service among some communities such as remoteness.
However, with the current infrastructure and government funding,
more work has been done to ensure that there is substantive equity
and that a particular population is not left out in terms of receiving
proper health care.

Equity in Nursing Home Care
cont.
iv) Substantive Equity (Population Perspective) cont.
 Reaching more community to provide affordable nursing home care
for the elderly has been a top priority for the government to ensure
that there are minimal disparities when it comes to delivery of these
services to the population.

Recommendations
To improve the quality of service that is offered in nursing homes, it is
essential to re-evaluate the current situation and find a sustainable
solution for the problems in the society.
 For instance, to ensure equity among patients, structures should be
created around the rules to make sure that people are not treated
differently due to their background or financial capacities.
 The government should also be involved in ensuring that the
provision of this healthcare service is affordable for all that are willing
to incorporate in nursing homes.

Recommendations cont.
 Government should ensure that patients receive improved quality of
services at all times.
 This could come in the form of changing the models through which
service is delivered, changing the payment as well as eligibility as well
as further research conducted to understand the factors that are
negatively affecting the delivery of services in this sector and
correcting those issues.

Recommendations cont.
 To conclude, it is the responsibility of everyone to
ensure that the service they pay for is what they get.
 Issues can always be raised with the relevant
authorities if cases of extortion are experienced and
the involved persons charged always to ensure fair
distribution of services.

References
• National Academy of Sciences. (2001). Improving the Quality of Long-
Term Care. Shaping the Future for Health, 1-8. Retrieved from
https://pdfs.semanticscholar.org/e494/ac95ffcdbf96f95d91a8057997
7f3d40fd30.pdf
• Clauser, S., & Harris, Y. (2002). Achieving Improvement Through
Nursing Home Quality Measurement. Health Care Financing Review,
23, 1-14. Retrieved from https://www.cms.gov/Research-Statistics-
Data-and-Systems/Research/HealthCareFinancingReview/
Downloads/Review_02Summerpg5_p.pdf

References cont.
• Frogner, B., Fondacaro, M., & Moos, R. (2005, March). Justice in
Health Care Decision-Making: Patients’ Appraisals of Health Care
Providers and Health Plan Representatives. Soc Justice Res., 1-12.
Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2878657/
• Piesse, E. (2017, May 22). Older Australians Opting for in-home Care
over Nursing Homes. Retrieved from ABC News:
http://www.abc.net.au/news/2017-05-20/growing-older-at-home-
cheaper-more-popular/8543848

References cont.
• Stadnyk, R., Lauckner, H., & Clarke, B. (2011, August 9).
Improving Quality of Care in Nursing Homes: What Works?
Retrieved from NCBI:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153508/
• WebMD. (2018). What Caregivers Should Know About
Nursing Home Care. Retrieved from WebMD:
https://www.webmd.com/health-insurance/nursing-home-
care#1

References cont.
• Woerkom, M. v., & Buljac-Samardžić, M. (2018, July 2). Improving
Quality and Safety of Care in Nursing Homes by Team Support for
Strengths Use: A Survey Study. Retrieved from PLOS one:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.020
0065
• Wynne, M. (2006, June). Home care in Australia. Retrieved from
http://www.bmartin.cc:
http://www.bmartin.cc/dissent/documents/health/hc_homecare.htm
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