Introduction
For decades now, the provision of effective and accessible home care
services for older adults has been touted as a solution to the
challenges posed by aging populations. However, in light of the recent
hecatomb of COVID-19 deaths in long-term care institutions, the
importance and urgency of optimizing home care services is stronger than
ever.
In this context, we conducted a large scale and broadly focused,
realist-inspired narrative review aimed at answering three questions.
First, what is home care? Though the term is commonly used as if the
definition was self-evident, the nature, boundaries and objectives of
home care vary a lot depending on jurisdictions and authors. Second,
what evidence exists on the effectiveness of home care models and
interventions? Many intervention-specific systematic reviews have been
published but few policy-level efforts exist that integrate insights
into the links between home care models and their outcomes. Third, what
is known about the causal processes involved in the production of those
effects? This last question aims at summarizing available evidence to
inform intervention design, optimization and evaluation. In conclusion,
our analysis suggests that three mechanisms (system integration, case
management and relational continuity) are core characteristics of home
care models’ effectiveness.