History: Home health care has emerged in two different forms i.e., post-acute care and social-supportive care (Kadushin & Egan, 6). Home health care was legally institutionalized in the United States post formulation of funded services such as Medicare and Medicaid legislation in 1965 with the former supporting post-acute skilled care to homebound individuals and the latter catering to preventive, skilled and unskilled care to chronically ill individuals. Prior to this, home care was not an entity of the government, but managed either by relatives or by private nurses. According to Keenan and Fanale (1989) the first home care program was started by Boston University in 1885 (qtd. in Kadushin & Egan, 6). Subsequently, home care health service has undergone many changes with respect to its scope, complexity, types of services, and other developments.
Current developments: Much of the development in home health care is attributed to increasing number of chronically ill patients post industrialization and improvement in public health systems. Moreover, home care was also viewed as a cost-effective method of treatment for both patients as well as hospitals. Implementation of Medicare and Medicaid programs have boosted home care services. Kadushin and Egan reported that in the past 20 years, medicare enrollees has been around 4 million and cost of home care has been around $20.5 billion (p.18). The National Association for Home Care and Hospice’s 2007 figures indicated that the Centers for Medicare and Medicaid Services expenditure touched $2.2 trillion (p.2). According to the Bureau of Labor Statistics (BLS), in 2006, about 867,100 caregivers were formally appointed by home care agencies.
Role of home care services: Most of the patients requiring home care services are those requiring postoperative care or rehabilitative care; in 2006, about 21.4 percent of home care patients had