This paper looks how different coordination centres for home care function in Flandres. In every of the five Flemish provinces, one coordination centre for home care was selected. A semistructured interview was taken, audiotaped and transcribed. Two independent researchers looked for the key issues. Secondly a written questionnaire was sent and analyzed. The results of both were discussed by two researchers up to a consensus regarding the answers.
It is apparent that there is a wide variation within these five centres in the involvement of local social instances, the provinces, the local sickfunds, the GP organizations and palliative networks. Fysiotherapists and farmacists are seldom involved in the organization of complex home health care. The degree of involvement varies between regions and within organizations. Finally, a wide variation exists in the number of handled cases and in the degree the coordination centre is the unique and first point of reference in the organization of complex home care.
We conclude that, despite an enormous body of legislation and control by the governement, on the field there exists a very wide variation in whether and how complex home care situations are organized. Only a minor fraction of these situations is cared for by the coordination centres. A new organization is recommended.
home care services, home care agencies,, Competitive Medical Plans, Patient Care Planning