especially the last ten years there have been enormous developments within the home health care. The main reason for this is the fact that the strain on health care resources grew bigger as a result of the ageing population and technological developments. For the home care there was an extra strain because of substitution processes. Hospital care is increasingly substituted to home care. All these strains put into motion many changes, that have become the subject of a political debate. The main question is: in what way can home organizations deliver a good quality of care in an efficient way for every person in need of this care?'A second question is: is there enough money to achieve this goal? To reach the goal of more efficiency, some trends can be distinguished, that affect the home care organizations and that will probably keep on influencing the home care field in the next few years.
Organization of home care
A trend of integration: From the original 300 organizations there are about 130 left. Not only is there a tendency within the same kinds of organization to merge, there is also an integration process between the nursing care organizations and the home help organizations, in order to be able to perform their tasks in a more efficient way.
Besides the integrating processes, there is a tendency to specialize in different forms of care.
Not only horizontal specialization has been introduced (specialists for the intake procedure, for the parent and child care, and for specific fields of the nursing care), also a differentiation in the vertical dimension took place (district nurses and auxiliary district nurses).
A trend towards competition and commercialization. Through changes in the financing of health care, the government tries to promote the founding of private home care organizations.
It is thought that the resulting competition will enhance efficiency.
