HOME HEALTH SERVICES
OBJECTIVE:
The objective of home health services is to identify patients receiving care at home who require examination, testing, treatment, medical care, social and psychological support, dressing, Specialist Physician consultation, and palliative care, and to initiate their treatment processes, ensuring that they receive high-quality services in a short time at home in coordination with hospitals.
SCOPE:
Home Health Services Coordination Center (ESKOM), Central Home Health Services (ESH), Healthy Aging Center (YAŞAM), and activities related to the provision of home health services are included.
HOME HEALTH SERVICES PATIENT ACCEPTANCE CRITERIA
DISEASE GROUPS COVERED BY HOME HEALTH SERVICES
Muscle diseases (Myopathy, Dystrophy)
Terminal stage cancer patients
Palliative care patients
Neurology patients (MS, Motor Neuron Diseases)
Physically disabled individuals
Chronic diseases
Oncology patients
Orthopedic and traumatology patients
Wound care and short-term nursing services
Patients temporarily bedridden due to fractures from traffic accidents
Patients over 80 years of age
CONDITIONS CAUSING BED-DEPENDENCY AND HOME DEPENDENCY
Cerebrovascular diseases
Muscle diseases
Neurodegenerative diseases
Cerebral Palsy
Traumatic brain injury
Spinal cord injury
Parkinson’s disease and other movement disorders
Alzheimer’s disease and other demential syndromes
Psychiatric disorders such as Major Depression, Pseudodementia, Dysthymic disorders
Bed-dependency due to advanced aging without any illness
Advanced obesity
Cancer patients
Patients with cardiopulmonary insufficiency
Rheumatic diseases
Orthopedic diseases
Physically disabled individuals
Diabetes and its complications
Fractures due to traffic accidents or falls
PATIENT CARE NEED ASSESSMENT AND IDENTIFICATION PROCESS
1. Patient application:
If patients are not registered in the Home Health Management System (ESYS), they contact the Home Health Services Communication Center (ESHİM) (444 38 33) national call center to register and apply for the first time. Patients already registered in ESYS are contacted via ESKOM, and the patient whose service is approved by ESKOM is assigned a service order to the relevant home health unit. Appointments are scheduled for patients with service order assignments in ESYS.
2. Appointment-based patient application:
Patients or their relatives registered in home health services contact their Home Health Center by phone or create an appointment through ESKOM via ESYS service order assignment. Additionally, patients or their relatives can also register through the Central Hospital Appointment System (MHRS) for YAŞAM Polyclinic applications.
GENERAL SERVICES
1. Emergency Priority Patients:
Home Health Services does not provide emergency medical services. If an emergency condition is detected during a routine visit, the patient is reported and referred to 112. The health team follows up until the patient is handed over to 112.
2. High Priority Patients:
Patients with bedsores (pressure ulcers)
Patients requiring nutritional and fluid support
Patients at high risk of infection
Patients with removed NG tube or catheter
Excessive vomiting
Wheezing
3. Medium Priority Patients:
Chronic disease follow-up (diabetes, hypertension, COPD, etc.)
Dressing, tube replacement, and injection needs
Rehabilitation and physiotherapy support
Patients requiring regular medication and testing
4. Low Priority Patients:
Control examinations
Periodic health monitoring
Visits for social support
Cases requiring simple medical consultation
Patients are distributed to ESH teams based on the patient’s location and priority.
Upon reaching the patient’s address, appropriate personal protective equipment is used, patient privacy is maintained, and services are provided at home.
Identity verification is performed according to the Identity Verification Instruction, detailed medical history is recorded in the patient file, and the patient or relative is informed about ESH and service withdrawal rules. Patient Acceptance/Refusal Form and Patient Information Sharing Consent Form are signed mutually.
The patient’s social security status, need for medical or social assistance, home hygiene, heating conditions, etc., are assessed.
The team physician performs a general physical examination. ANT is recorded. The patient is evaluated for pain, falls, edema, pressure ulcers, nutrition, and allergies, and data are recorded in the patient file.
PLANNING OF MEDICAL CARE NEEDS
Initial assessment during patient visits is performed by the team physician.
Patient visits are planned according to medical care needs by the team.
Planned medical care is recorded in the Medical Care Plan Form and applied at specified intervals, while the patient/relative is informed about the plan.
Prior to each care request, the patient/relative is instructed to call ESHİM or the ESH contact number to make an appointment.
Changes in the medical care plan are determined by the team physician, and the patient/relative is informed accordingly.
POSSIBLE NECESSARY CHANGES IN MEDICAL CARE PLAN:
In cases of general weakness, the patient’s previous tests and general examination are reviewed, and contact with palliative services is made for potential hospitalization.
If general deterioration is detected, the patient is referred to 112.
After the general examination, based on patient/relative complaints, referral to the previously consulted Specialist Physician is made if necessary.
If wound care by ESH teams and training provided to relatives shows no improvement, the patient is referred to the appropriate clinic.
When treatment updates are required, the ESH team contacts the relevant Specialist Physician, updates patient care, and records in the Doctor’s Notes section of the Patient Evaluation, Monitoring, and Follow-up Form.
MEDICAL SOCIAL SERVICE APPLICATIONS
Psychological Support: For patients requiring psychological support, consultation is obtained from psychiatry clinics of the affiliated hospital.
Physical Therapy and Rehabilitation Applications: Patients evaluated by ESH physicians receive appropriate physical activity and movement training. Those needing treatment are referred to physiotherapy units.
Dietitian Support: For patients needing dietitian support, consultation forms are completed and sent to the hospital’s Diet Services Unit. Necessary actions are initiated by the dietitian.
Medical Social Support Service: For patients requiring medical social support, a Consultation Request Form is completed and submitted to the hospital’s social service unit. Actions by social services are recorded in the relevant sections of the Consultation Request Form.
SERVICE TERMINATION PROCESS
ESH service is terminated using the ESH Service Termination Form in cases of patient recovery, noncompliance by the patient or family, request to terminate service, improvement sufficient for family care, change of residence, death, or inappropriate behavior toward staff.
Upon recovery, the patient is referred to the family physician.
In case of change of residence, service is terminated and the new local ESH unit is notified via ESYS.
In case of death, service termination is processed using MERNİS based on the date of death.
CONDITIONS WHERE HOME HEALTH SERVICE CANNOT BE PROVIDED
Patients cannot be accepted into home health services under the following conditions:
a) Medical contraindication determined by a hospital physician for performing the requested treatment at home, even with healthcare personnel,
b) Lack of necessary equipment or trained healthcare personnel provided by the healthcare institution for home treatment of the patient or patient group,
c) Court-mandated hospitalization or medical observation/treatment due to mental illness, psychiatric disorder, or substance addiction.
HOME HEALTH SERVICES – 2025
Number of Specialist Physicians: 1
Number of General Practitioners: 5
Number of Nurses/Health Officers: 12
Clerical Staff/Secretary: 3
Drivers: 2
Team Vehicles: 6
Equipped Patient Transport Vehicles: 1
Total Registered Patients: 1910