European Journal of Ageing

, Volume 4, Issue 3, pp 133–140

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

  • Mikkel Vass
  • Rasmus Holmberg
  • Henrik Fiil-Nielsen
  • Jørgen Lauridsen
  • Kirsten Avlund
  • Carsten Hendriksen
Original Investigation

DOI: 10.1007/s10433-007-0056-2

Cite this article as:
Vass, M., Holmberg, R., Fiil-Nielsen, H. et al. Eur J Ageing (2007) 4: 133. doi:10.1007/s10433-007-0056-2
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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

Older peoplePreventive home visitsMunicipality interventionCare managementMunicipality organisation

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Mikkel Vass
    • 1
  • Rasmus Holmberg
    • 2
  • Henrik Fiil-Nielsen
    • 2
  • Jørgen Lauridsen
    • 3
  • Kirsten Avlund
    • 4
  • Carsten Hendriksen
    • 4
  1. 1.Department of General Practice and Central Research Unit for General Practice, Institute of Public HealthUniversity of CopenhagenCopenhagen KDenmark
  2. 2.Department of Political ScienceUniversity of CopenhagenCopenhagenDenmark
  3. 3.Institute of Public Health–Health EconomicsUniversity of Southern DenmarkOdenseDenmark
  4. 4.Department of Social Medicine, Institute of Public HealthUniversity of CopenhagenCopenhagenDenmark