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Published:
Care bands - a useful way to allocate resources for healthcare at home?
Lead researcher: Joan Quigley, Research Officer, the Health Research Board (HRB)
The problem
The Irish healthcare system wants to support older people and adults with disabilities to live independently by providing care and support in the home. Might grouping people into ‘care bands’ based on their needs help to ensure they get the care they need and that care providers are reimbursed appropriately?
The project
The Department of Health asked the HRB to examine the international evidence for allocating people into ‘care bands’ based on their care needs, compared to other reimbursement systems, such as paying healthcare providers on a flat rate or fee-per-service basis. The HRB carried out a systematic review of 46 studies published between 1990 and 2020 and evaluated the impact of using care bands to allocate resources in six countries.
The outcomes
- The study described how care bands have been used to classify care needs in Australia, Canada, Germany, the Netherlands, New Zealand and the United States of America
- We now know that linking care bands to service or resource allocation resulted in increased costs of healthcare in some countries
- The review showed that using a reimbursement system based on care bands had little impact on the quality and outcome of care
- We have evidence that a care band system could reduce access to care where the person has very complex needs
- The findings are now being used to help inform a care band allocation system for Ireland.
Dr Kathryn Lambe, Research Officer with the HRB Evidence Review Team and a co-author on the report, says:
“When we looked at the existing studies of care bands and allocation of resources for home supports, we could see that many had a low degree of certainty. That said, from the systematic review we could see that using care bands to allocate resources generally didn’t affect the level and quality of care itself. But there are things to watch out for, particularly a rise in cost and to ensure that people with the most complex needs have access to the care they need. We have shared the findings with the Department of Health and the HSE, so they can help inform how a home-support system could be financed in Ireland.”
"Care bands - a useful way to allocate resources for healthcare at home?" is part of a wider collection of success stories across four themes from this year's annual Health Research in Action.