can home organizations deliver a good quality of care ill all 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.
Screen 39 (home care: organization of home care)
At first there is the 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. The idea was and is that by integration the organizations can perform their tasks in a more efficient way. About 35% of the now existing organizations are integrated organizations, that is, they deliver nursing care as well as home help.
Besides integrating processes, there is also a tendency to differentiate, namely in forms of care. Formerly, the district nurses were generalists. They performed the intake procedure, they provided nursing care at home, they took care of the preventive health care to mothers and children, etcetera. Nowadays, all these tasks are done by specialist nurses. There are also specialists for specific fields of the nursing care, like a specialist nurse for patients with diabetics, a specialist nurse for patients with cancer. Specialization in a vertical dimension took place by introducing two types of district nurses: district nurses and auxiliary district nurses. In the home help field the same process of differentiation has taken place.
Another trend is the 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. This
