The effectiveness and efficiency of providing home care visits in nursing clinics versus the traditional home setting
Bibliographic record
Abstract
Objectives . (1) Develop and implement a new model of home care delivery for home care services that would better serve post acute clients; (2) Evaluate this process by determining the effectiveness of the new model; (3) Suggest how the model would complement and be assimilated with the acute and community health care sectors; (4) Determine if the model is a more efficient way to use nursing resources; (5) Determine the satisfaction and acceptability of the clients and nursing staff with the new model. New service . Three nursing clinics were built, equipped and staffed to operate in three geographically different areas of a large Canadian city. The clinics served post acute, ambulatory Community Care Access Centre (CCAC) clients requiring wound dressings, intravenous therapy and other complex nursing care. Research design . Randomized control trial with initial data collection immediately post randomization and six weeks post discharge from hospital. Sample size . 99 Clients (45 experimental and 54 control), average age 50.8 years, eligible for CCAC services and retained for a 6 week period post CCAC discharge. Results . Study participants treated in a nursing clinic versus at home maintained their equivalent health status on eight health dimension and two summary mental and physical component scales of the SF-36. The average number of visits per clients in either venue was not significantly different. The average treatment time in the home was 46.4% longer (p < .001) than the clinic when travel and documentation time was included. This saving translates into a potential $10 million savings and the release of 146 full time equivalent RN resources, based on 6 million home care visits annually in Ontario. In addition, the satisfaction results reveal the home group was significantly less satisfied and inconvenienced waiting to be treated in the home. Implications . This study demonstrates that nursing clinics are an effective, acceptable and more efficient alternative for home visits for certain groups of clients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.027 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".