Display options
Share it on

Eur J Ageing. 2007 Aug 22;4(3):133-140. doi: 10.1007/s10433-007-0056-2. eCollection 2007 Sep.

Preventive home visitation programmes for older people: the role of municipality organisation.

European journal of ageing

Mikkel Vass, Rasmus Holmberg, Henrik Fiil-Nielsen, Jørgen Lauridsen, Kirsten Avlund, Carsten Hendriksen

Affiliations

  1. Department of General Practice and Central Research Unit for General Practice, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
  2. Department of Political Science, University of Copenhagen, Copenhagen, Denmark.
  3. Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark.
  4. Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.

PMID: 28794782 PMCID: PMC5546277 DOI: 10.1007/s10433-007-0056-2

Abstract

The organisational influence on benefits of preventive home visitation programmes for older people has escaped scientific evaluation. This study aims to investigate organisational structures and processes in relation to preventive home visits. As part of a randomised controlled trial investigating whether educational intervention towards municipality health care professionals could enhance active life expectancy, information of municipality leadership, home visit approach, strengths and limitations of communication within the organisation were obtained using individual and focus group interviews. Thirty-four municipalities in four counties participated. Data was systematically condensed using a phenomenological approach upon which general patterns were categorised into a theory-based formal typology of the preventive home visitation management in the municipalities. Three distinct strategies for preventive home visitation programmes were identified. Eighteen municipalities were categorised as "Framework Management", 15 as "Management by Rules" and one as "Project Management". Small municipality size was associated with the "Framework Management" type. "Management by Rules" municipalities had higher population densities and their overall expenses for older people were higher. "Framework Management" municipalities used more resources on preventive home visits, communicated better, experienced less staff changing and had higher social capital than "Management by Rules" municipalities. Municipality structures and management processes of preventive home visitation programmes varied considerably in 34 Danish municipalities, but the majority could be categorised as using either a "Framework Management" or a "Management by Rules" strategy. Each strategy is associated with particular advantages and disadvantages, which may explain differences in the overall benefit of the programme between municipalities.

Keywords: Care management; Municipality intervention; Municipality organisation; Older people; Preventive home visits

References

  1. Lancet. 2001 Aug 11;358(9280):483-8 - PubMed
  2. BMJ. 2001 Sep 29;323(7315):708 - PubMed
  3. BMJ. 2001 Sep 29;323(7315):719-25 - PubMed
  4. JAMA. 2002 Feb 27;287(8):1022-8 - PubMed
  5. Aging Clin Exp Res. 2002 Dec;14(6):509-15 - PubMed
  6. Eur J Public Health. 2003 Sep;13(3 Suppl):107-13 - PubMed
  7. Scand J Prim Health Care. 2004 Jun;22(2):106-11 - PubMed
  8. J Am Geriatr Soc. 2005 Apr;53(4):563-8 - PubMed
  9. Eur J Public Health. 2006 Oct;16(5):559-64 - PubMed

Publication Types