Joanne Spetz (
Robyn I. Stone is senior vice president for research at LeadingAge, in Washington, D.C., and codirector of the LeadingAge LTSS Center at the University of Massachusetts, Boston.
Health Aff (Millwood). 2019 Jun;38(6):902-909. doi: 10.1377/hlthaff.2019.00021.
Home health and personal care aides are one of the largest groups of health care workers in the US, with nearly three million people providing direct care for people with serious illness living in the community. These home care workers face challenges in recruitment, training, retention, and regulation, and there is a lack of data and research to support evidence-based policy change. Personal care aides receive little formal training, and they experience low pay and a lack of respect for the skill required for their jobs. High turnover and occupational injury rates are widely reported. There is little research on the factors associated with higher-quality home care, the extent to which worker training affects client outcomes, and how regulations affect access to and quality of home care. Health care leaders should seek to fill these gaps in knowledge, support the establishment of training standards and programs, implement Medicaid reimbursement strategies that incentivize improvements in pay and working conditions, reform regulations that now prevent the full utilization of home care workers, and create sustainable career pathways in home care policies.
家庭保健员和个人护理员是美国最大的医疗保健工作者群体之一，有近 300 万人为社区中患有重病的人提供直接护理。这些家庭保健员在招聘、培训、留用和监管方面面临挑战，而且缺乏数据和研究来支持基于证据的政策改革。个人护理员接受的正规培训很少，他们的工资低，工作所需的技能也得不到尊重。高离职率和职业伤害率屡见不鲜。关于哪些因素与高质量的家庭保健相关、工人培训对客户结果的影响程度以及监管如何影响家庭保健的可及性和质量，相关研究很少。医疗保健领导者应努力填补这些知识空白，支持制定培训标准和计划，实施医疗补助报销策略，激励提高薪酬和工作条件，改革现有的阻止充分利用家庭保健员的法规，并在家庭保健政策中创建可持续的职业发展途径。
