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In the following years, the world population will keep growing and, simultaneously, there will be more and more chronic diseases. The current hospitalisation infrastructures cannot live up to this changing context and have to rethink to new processes. One of these processes is known as home care. Even if the idea is to propose the same quality of cares at home than at hospital, the home care services have to face different logistic problems. Some of them have already been met in the hospital logistics, some other are entirely new. 

Therefore, this paper aims at analysing the logistics problems in the home care systems in the Belgian home care systems. To this end, real-life interviews and a review of the scientific literature will be carried out. The main goal is to identify the gaps, if any, that could exist between the literature and the Belgian reality. Moreover, the paper describes the current solutions to problems met in the Belgian home care systems, once again based on the array of interviews that have been carried out. In the literature, we observed four main problems: (1) the network design, (2) the production and suppliers of medicines, (3) the nurses routing, (4) and finally, the management of inventory. Otherwise, this paper suggests a mathematical model for the nurses routing, suitable in the Belgian home care systems. After some interviews with members of Belgian home care systems, we are truly able to say that there is a gap between the literature and the reality. However, those problems are not always developed in the reality when they effectively occur. 

This paper is divided into five parts. It starts with the presentation of the concept of home care with some details of financing and foreign models. Then, we carry on with the main differences existing between the industrial logistics, hospital logistics and home care logistics, including some comments about information systems and key performance indicators. In addition, we highlight the logistic problems of home care met in the literature such as routing problem, districting problem and also, carry out a comparative analysis of the studied logistic problems. Finally, as a last chapter, we develop the used methods to achieve the goals of this paper.

home care, home health care, home care logistics, logistic problems in home care, logistic problems in home health care, literature review, Belgian Home Care. --- Sciences économiques & de gestion > Production, distribution & gestion de la chaîne logistique

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Home care services --- Home Care Services --- Home Care Services. --- Home care services. --- Home health agencies --- Home health care --- Care Services, Home --- Home Care --- Services, Home Care --- Domiciliary Care --- Care, Domiciliary --- Care, Home --- Home Care Service --- Service, Home Care --- Community health services --- Nursing --- Home Health Care

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In order to cope with the growing demand for hospitalisation and to improve patient satisfaction, alternatives to traditional hospitalisation are being developed all over the world. One of them is the hospital at home.
Therefore, the objective of this thesis is to highlight promising research questions in the area of tactical planning for the hospital at home and to see what implications this has at the short-term level. More specifically, this thesis aims to answer the question: How can tactical planning models for the hospital be adapted to take into account the case of the hospital at home and what are the impacts at the operational level?.
To this end, the thesis will begin with a literature review that will focus on decisions made in hospitals and home health care institutions. All three levels of decisions will be studied, but particular attention will be paid to the tactical level. Then, more information about hospital at home will be given. This part will include a reminder of the differences between home health care and hospital at home. The development of hospital at home in several countries will also be analysed. Finally, the results of the interviews conducted in the framework of this thesis will be presented. These interviews were carried out in various Belgian hospitals offering a service of hospital at home. The last part of the thesis will discuss the adaptations to be made to the hospital’s decision‐making models when the case of hospital at home is considered and will also address the impact of these modifications on the operational level.
As a result, it was seen that there were fewer changes at the tactical level than expected. But that the few changes impacted more strongly on the operational level. Moreover, the changes mainly concern nurses, who are one of the most important resources of the hospital. In addition, the hospital at home could increase the capacity to admit patients, but on the other hand, the hospital would be faced with a lack of staff. At the tactical level, it is therefore wise to think carefully about the selection of shifts and the number of staff per shift, so as not to complicate the daily/weekly management of the nurses.

Hospital at home --- Home health care --- Tactical planning --- Nurses --- Patients --- Sciences économiques & de gestion > Production, distribution & gestion de la chaîne logistique --- Sciences économiques & de gestion > Domaines particuliers de l'économie (santé, travail, transport...)

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Home care services --- Social case work --- Long-term care of the sick --- Home care services. --- Long-term care of the sick. --- Management --- Management. --- Home health agencies --- Home health care --- Case work, Social --- Casework, Social --- Social casework --- Community health services --- Care of the sick --- Medical care --- Social service --- Counseling --- Friendly visiting --- Interviewing

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Often the switch to telecare technology used to help caretakers provide treatment to their patients off-site is portrayed as either a nightmare scenario or a much needed panacea for all our healthcare woes. This widely researched study probes what happens when technologies are used to provide healthcare at a distance. Drawing on ethnographic studies of both patients and nurses involved in telecare, Jeannette Pols demonstrates that instead of resulting in less intensive care for patients, there is instead a staggering rise in the frequency of contact between nursing staff and their patients. 'Care at a Distance' takes the theoretical framework of telecare and provides hard data about these innovative care practices, while producing an accurate portrayal of the pros and cons of telecare.

Ethics, Medical. --- Medical ethics. --- Primary health care. --- Home care services --- Telecommunication in medicine --- Medical informatics --- Medical ethics --- Patient Care --- Information Science --- Telecommunications --- Medicine --- Health Services --- Informatics --- Delivery of Health Care --- Therapeutics --- Patient Care Management --- Health Care Facilities, Manpower, and Services --- Communications Media --- Health Occupations --- Health Care --- Disciplines and Occupations --- Health Services Administration --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Medical Informatics --- Nursing Care --- Telemedicine --- Public Health --- Health & Biological Sciences --- Home Health Care Services --- Technological innovations --- Telecommunication in medicine. --- Telecare (Medicine) --- Biomedical ethics --- Clinical ethics --- Ethics, Medical --- Health care ethics --- Medical care --- Moral and ethical aspects --- Bioethics --- Professional ethics --- Nursing ethics --- Social medicine --- Medical informatics. --- Technological innovations. --- Clinical informatics --- Health informatics --- Medical information science --- Information science --- Home health agencies --- Home health care --- Community health services --- Data processing --- Home care services - Technological innovations