Improving Service Quality of Home-Based Health Care Services for the Elderly: A Qualitative Study of Facilitators and Barriers Reported by Community Health Workers in Beijing.

BACKGROUND

As the population ages, the growing demand for elderly care has become a multi-faceted issue, encompassing the health of individuals, the viability of healthcare systems in addition to family and societal pressure. This study aims to identify the associated factors and provide recommendations to inform the better implementation of home health care services in Beijing.

METHODS

This study was a qualitative study in which 13 individuals were selected for focus group interviews through purposive sampling to understand the current status of home-based health care service provided by Beijing's community health service organizations, and to categorize facilitating and barriers factors into the five domains of the Consolidated Framework for Implementation Research (CFIR), a comprehensive framework for implementation research, and to derive targeted recommendations by using the expert recommendations for implementing change (ERIC).

RESULTS

Of the 13 study participants, 4 (30.77%) were physicians, 9 (69.23%), were nurses and 8 (61.54%) were involved in the management of home-based health care service. The main facilitators included Intervention Source, Evidence Strength and Quality, and Adaptability; Local Attitudes, Conditions, and Cosmopolitanism; Relationship Connection, Incentive System; and Motivation. Major barriers identified included Design Quality and Packaging, Cosmopolitanism, Peer Pressure, Available Resources, Structural Characteristics, Access to knowledge and information, Key Stakeholders, and Planning. To address the barrier factors, CFIR-ERIC matching tool was utilized to make recommendations. Importance was determined by cumulative selection rate, resulting in multiple improvement strategies.

CONCLUSIONS

The provision of home-based health care service by Beijing's community health service organizations meets some of the needs of participants in this study reported, but there are still some barriers that can be further improved with reference to the ERIC recommendations.