Journal Article

Home Care Practices and Challenges Among General Practitioners in Modena

Palandri, L, Leonelli, L, Lugli, C, Ugolini, G, Riccomi, S, Fornaciari, D, Righi, E, Salvia, C, Fantini, S, Serafini, A

2025

Overview

Abstract Introduction Aging populations necessitate home care, but Italy's plan to increase coverage lacks implementation specifics alongside regional variability. Furthermore, there is no data on Italian GP's HC delivery. This study examines home care delivery by General Practitioners in Modena province. Methods A cross-sectional study was conducted involving 85 volunteer GPs (19% of the province's total GPs) from all seven districts of Modena province. Data were collected through a knowledge questionnaire on home care attitudes and analyzed alongside administrative data from December 2022, including active HC contracts, hospitalization rates, and emergency department access. Results 75% of respondent GPs were female, with an average age of 50 years. The average patient load per GP was 1362, with significant variability in age distribution. Most GPs worked in group practices (67%) and utilized support staff, including nurses (66%) and secretaries (86%). 44% of GPs reported conducting 3-5 home visits weekly, 58% activated HC contracts for less than half of their non-transportable patients. The main barriers in activating these contracts were a preference for need-based visits, time constraints, and bureaucratic hurdles. Contracts were mainly for Integrated HC (56%) and Planned HC (41%). GPs managed an average of 15 contracts each (range 2-44), with significant variability in contract types. Hospitalization rates for enrolled GPs (62.3 medical, 41.7 surgical per 1,000 patients) were lower than the provincial average (66.4 and 42.7, respectively). Conclusions The findings highlight the need for Local Health authorities to streamline processes to support HC services, addressing identified barriers and optimizing patient care. The study underscores the importance of providing a comprehensive description of home care services to inform healthcare reforms and improve evidence-based decision-making. Key messages • The study shows variations in home care delivery among GPs in the province of Modena, highlighting challenges and the impact of local healthcare organization. • Findings emphasize the need for streamlined processes and support to improve home care services, addressing barriers and optimizing patient care.

• Publisher: Oxford University Press
• Subject: Age composition / Age distribution / Aging / Attitudes / Averages / Barriers / Bureaucracy / Contracts / Cross-sectional studies / Data / Decision making / Domiciliary visits / Emergency medical care / Emergency medical services / Emergency services / Family physicians / Health authorities / Health care / Health services / Home health care / Hospitalization / Load distribution / Local health authorities / Nurse led services / Nurses / Patients / Physicians / Poster Displays / Regional planning / Secretaries / Variability