PLANNING HOME CARE SERVICES - WHICH DATA DO WE NEED

In Italy, as is true throughout the developed world, care in the home is becoming central to the delivery of almost all health care services to much of the population: especially those who are elderly. Although there are many reasons why this Is true, including the dramatic chang es in the demographic characteristics of the population being served, financial considerations are surely the proximate and most visible cau se. As Diagnostic Related Groupings (DRG) are introduced with a fixed payment for acute institutional care for a given condition, regardless of the duration of stay, hospitals will increasingly have an incentiv e to shorten the period of hospital care. This will necessitate the pr ovision of much care, previously provided on an in-hospital basis, to be delivered in the home setting. These changes in the site of care wi ll demand considerations about the education of all types of professio nals but especially physicians who traditionally have had little direc t involvement in care in the home. In addition, there will be a requir ement for an expansion in health care research so that comparisons of services and sites can be carried out with an eye to determining the m ost cost-effective way to provide for care, Lastly, epidemiologic stud ies will be needed to address the risk factors of those chronic diseas es so frequently a cause of functional impairment requiring home care services.