The Decision Maker Survey

Here again it was required to gather information on:

• the current use of IST products and services
• the demand (potential and actual) for IST products and services
• mediating factors

This includes :

• Current usage of IST including, e.g.
• • usage of IST services and devices within the organisation
  • experienced usefulness/benefits
• Potential and actual demand including, e.g.
• • anticipated potential for supporting care/support services currently offered to the clients
  • anticipated risks/problems referring to IST implementation
  • awareness of IST
  • IST-related needs inferred from profile of clients and services provided
  • strategies/plans referring to purchasing IST
  • anticipated mid range demand for IST
  • mediating factors including, e.g.
  • experiences referring to IST
  • legal/organisational status
  • size of the organisation

Care services for older people

Care for older people in Europe is being provided in different contexts and by a range of organisations. This includes medical care, social care as well as care related to activities of daily living such as for instance house keeping. Services include:

• Day care
• Respite care
• Chore services
• Home health care
• Homemaker services
• Meals on wheels
• Friendly visitors/ escort services
• Caregiver support groups
• Congregate meals
• Senior centres
• Transportation Services
• Mental health services
• Housing

The heterogeneous structure of the European care market

Due to the diversity of the field in question, comparable information at European level is not available as regards the levels of provision and the relative importance of these various services in the different countries. A considerable amount of pioneer work would be required in order to generate such an overview . The demographic changes in the European society among other things bring about institutional reforms of the legislatory framework and thus lead to a rapidly changing European market structure for care and related services. To gain structural data about this market remains a field where further research is needed.

DMS focus: care services to or at the client's home.

Against this background, the SeniorWatch project focused its efforts in order to enable the collection of Europe-wide comparable empirical information within the given resource limitations. Therefore, the decision maker survey focused on organisations providing care services to or at the client's home. This included various service components as illustrated in the table below. The decision to focus the decision maker survey on home care providers was based on the following reasons:

• Home care is the most prevalent form of care service delivery to older people in Europe. It is estimated that only about 5% of the European older population live in institutional settings.
• The home care sector is growing in all European countries. Almost all European Member States pursue a policy which explicitly prefers home care instead of institutional care. Some countries have even implemented a moratorium with regard to building new institutional homes for older people .
• Although there is a lack of robust empirical data with regard to the forms of support that older people would prefer, there are indications that most people prefer home care instead of institutional care. For instance, many older people increasingly see public home care services - when they become necessary - as a public right . In view of demographic developments, the market potential for home care-related IST applications can thus be expected to grow considerably in the near future.
• In the case of home care, services need to be delivered at dispersed geographic locations (i.e. the clients' homes), and IST can be of particular importance when geographic distances need to be overcome.

EXAMPLES OF COMMON HOME CARE SERVICES

Nursing	Support within the home environment	Support outside the home environment	Consultancy	Other
Continuous care Timely restricted medical care/ treatment	Cleaning, Laundry/ Ironing, Meals Gardening Cooking	Transport Shopping Accompanying-Services Meals on wheels Animal-keeping	re administrational issues re psychological problems for family-carers re housing-adaptation	Emergency-call-centres Leisure-time-offerings

Source: SeniorWatch, 2001

The organisational and institutional structures of the home care sector vary considerably across Europe, and little comparable information is available . In some countries, a variety of care service provider organisations can be observed, including not-for-profit organisations as well as commercial service providers. In other countries, the home care sector is quasi monopolised by the municipalities. Moreover, there are some countries where informal home care through family members seems to dominate, and professional care appears to be provided only at health/social care facilities. Other countries aim at complementing informal care by professional care in the community.

Accordingly, organisations providing home care differ with regard to their legal status, their organisational profile and the scope of service delivery. Overall, three main types of service providers can be distinguished:

• public institutions of the federal states/provinces/departments and the municipalities
• welfare organisations, including church organisations
• private service providers

DMS Sampling approach

Against this background, the following sampling approach was developed for the DMS:

• The sample represents decision makers from organisations providing care services to older people living in the community, i.e. in their own home environment.
• For the purposes of the decision maker survey, a decision maker can be defined as
• • the owner of a care service organisation,
  • or the managing director of a care service organisation,
  • or an executive employee with decision power at the strategic level or on IT investments or on personnel.
• For the purposes of the decision maker survey, the organisational entity to be considered for sampling can be defined as:
• • an organisation which operates only locally or in a (limited) regional context
  • from nationally operating organisations decision makers in a regional office or those who are responsible for a particular region or area/larger city were interviewed.
• Because of the missing structural market information, a quota procedure was utilized representing the dimensions of urbanity and size of establishment.

Overall, the net sample was comprised of some 500 decision makers across Europe (100 for Germany, 50 for Spain, France, Italy, and the UK, 20 for Belgium, Denmark, Greece, Ireland, the Netherlands, Austria, Portugal, Finland, and Sweden, and 10 in Luxembourg).