A model proposal for the integration of home care services in Turkey

The concept of home care service, which is getting more and more important worldwide and in Turkey, does not have a standard framework in national and international area in terms of definition, scope, criteria of service delivery, and quality works. In Turkey, the Ministry of Health, the Ministry of Family, Labor and Social Services, and municipalities conduct home care services independently of each other. In this regard, the purpose of this thesis is to provide a model proposal for the integration of the Ministry of Health, the Ministry of Family, Labor and Social Services, and municipalities in terms of home care services that need to be provided in a holistic structure as health and social care service. The study employed the phenomenological design, which is a qualitative research method. This design was adopted because it would provide advantages in defining the current situation of home care services and detecting the works performed by institutions within the context of home care services for constructing an integration model. Data were collected through interviews with local level unit supervisors of institutions providing home care services. In-depth interviews were conducted with a total of 12 unit supervisors through semi-structured interview form. The data obtained from the interviews were transferred to the electronic environment. They were analyzed after being divided first into codes and then into themes via Nvivo 12. The findings of the study show that the Ministry of Health, which is actively involved in home care service delivery, provides home care services while the Ministry of Family, Labor and Social Services provides financial support, and municipalities provide health and social care. Besides the differences between the services provided by the said institutions, there were also differences in terms of the definition of home care, criterion of service delivery, quality works, financing, legal foundations, human resources, materials, and technological infrastructure. To ensure the integration of services, a framework must be set for the definition of home care services, the services to be provided, the prerequisites to be applied in service delivery, quality measurement standards, financing, quantitative and qualitative characteristics of staff to deliver services, and quality improvement and performance evaluation works in accordance with legal regulations. The findings indicate that the number of employees delivering services is inadequate; their number should be increased for the sustainability of home care services; and staff specialized in certain areas should be included in relevant units. Because there is no official communication channel between the institutions delivering services, employees contact relevant units or redirect individuals in need of service to relevant units through informal communication. Thus, information infrastructure should be constructed to provide data flow and communication. In addition, the accessibility and updatability of the information infrastructure by all units is important for the collection of up-to-date data at first hand. The study proposes integrating the Ministry of Health, the Ministry of Family, Labor and Social Services, and municipalities by putting the units affiliated to the Ministry of Health in the center and using SSI and user contributions for financing