Abstract
Rationale, aims and objectives: There is a large body of
literature from all over the world that describes, analyzes, or
evaluates home care models and interventions. The present article aims
to identify the practical lessons that can be gained from a systematic
examination of that literature. Method: We conducted a three-step
sequential search process from which 113 documents were selected. That
corpus was then narratively analyzed according to a realist review
approach. Results: A first level of observation is that there are
multiple blind spots in the existing literature on home care. The
definition and delimitation of what constitutes home care services is
generally under-discussed. In the same way, the composition of the
basket of care provided and its fit with the need of recipients is
under-addressed. Finally, the literature relies heavily on RCTs whose
practical contribution to decisions or policy is disputable.At a second
level, our analysis suggests that three mechanisms (system integration,
case management and relational continuity) are core characteristics of
home care models effectiveness. Conclusion: We conclude by
providing advice for creating effective home care system change through
rational and participatory design and evaluation alongside public
dialogue about the purpose and future of home care.