Challenging Issues in Evaluation of Home Care Services

Developing and introducing new policy measures and services for older people is a necessity in developed countries owing to rapid population ageing, related changes of family structures, and women’s participation on labor market. Evaluation of quality of policy measures is an established part of public policies including different levels of evaluation such as nationwide administrative monitoring of services as well as users’ oriented evaluations. Home care is a service designed to provide care to recipients own homes by care professionals and can vary from social care to community nursing or respite care. In Slovenia, the social home care was introduced on national policy level in 1992. Development of service was slow and fragmented. Detailed analyses of administrative data about organizational features such as number of users, the price of the service for users, the times of the day and week when service was delivered to recipients homes showed strong variations across municipalities (Hlebec 2010, 2013). The first representative survey of users of social home care, carried out in 2013 revealed that there is a group of users (about 20%) that find the service rather unsatisfactory mostly owing to intensive need for care (Hlebec and Filipoviè Hrast 2014). In this presentation we will explore satisfaction with access (Penchansky and Thomas, 1981; availability, accessibility, accomodation, affordability, acceptability) from perspective of users and at the same time from perspective of their informal carers. First exploration of satisfaction with access shows that social home care users are unable to distinguish accomodation from acceptability and evaluate satisfaction with performance of formal carers as a single dimension while their informal carers distinguish between the two dimensions of quality. We will discuss implications of our findings with regards to quality of social home care, evaluation practices and methodologies.