Home, sick: Implications of health care delivery in the home

Changes in technology as well as new policies concerning the public and private sectors have encouraged the growth of new activities in the home, including the care of people who previously would have been treated in a hospital. A good deal of interest in this issue has been generated in Sweden as of late, partly because of the promise of more humanitarian health care but also because of a hope that such reforms could lead to a reduction of public expenditures. The purpose of this article is to explore various consequences which may arise when schemes for health care in the home are implemented. The focus is on arrangements whereby patients are treated for a serious illness and spend their time recovering or receiving treatment in their own place of residence. Emphasis is placed on how being sick at home might affect the individual in question, how the position of other household members might be altered, and how relationships with health-care workers might evolve. In each case, the article attempts to show the variety of ways ("positive" as well as "negative") in which the use and meaning of the home may be altered.