1. Integration Of Home Care; “How To Deal With This Difficult Task?” ÜNALAN C.Pemra, ÇİFÇİLİ Serap Marmara University Medical FacultyDepartment of Family Medicine Home Care Unit of the Hospital 10 September 2013 EFPC/ İstanbul

2. Integration of Home Care within levels of health care; different sectors; governmental and non- governmental organizations and different branches of care. Purpose: To discuss opinions and experiences of the participants in terms of integrating home care in a country which is in a transformation period of primary health care services and recently organized home care service delivery.

3. A new health delivery system has been introduced in 2003 by the Turkish MoH. primary and secondary care were reorganized. “home visit or calls” were defined to be delivered by primary health care workers and nurses were allowed to deliver private home health services, too. hospital based home health services have been started without creating the necessary environment.

4. But, none of these met the current definition of “home care”. Services enabling people to living in their home environment In 1996, private organizations started to deliver home care services. totally paid by the patients no legal regulation at that time the need to service was extremely great, private sector was soon followed by local administrations limited to design of the organizations!!!

5. In 2005, with the help of the efforts of the service deliverers and non-governmental and academic organizations working in the area, a by-law was announced by MoH called “Regulation of Home Health Services”. In 2004, a few governmental hospitals, mostly located in small towns started to deliver home health services. No payment by the Social Security System due to lack of regulations.

6. “Regulation of Home Health Services Delivered by Ministry of Health” in 2010, and rapidly organized hospital based services across the Country. At least; the payment system was declared!!! A “window dressing” activity without any background organization. Preventive health services of home care, primary level health services and follow-up of chronic diseases of home-bound patients, was defined as duty of primary care team.

7. As a conclusion; In Turkey there are many different organizations of home care in the field. Social home care services are directed by an other govermental organization. We as a country have many organizations that allocated resources to better meet the needs of this population. Lack of the experience of care coordination for people with multiple health and social needs,  a methodical approach to deliver integrated service,  human resources trained appropriate for this issue,  standarts to deliver the home care service  to measure the outcomes while ensuring efficient access to the health care system.

8. Evidence suggests that Integrated Home Care, which could be defined as; “integrated pathway between hospital services, primary care and social services for patients with home care” What strategies can be used to integrate home care services within different levels of care?  How could social and health aspects of home care be integrated? What is the role of reimbursement system in integration of home care?

9. Thank You... Şeker Ahmet Paşa