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Measuring unmet needs to assess the quality of home health care.

Until now home care research has been primarily focused on functional limitations. The instrument presented in this article also takes into account needs for psychosocial care, extra information, nursing care, and extra arrangements such as adaptations of the house. Elderly people with a chronic disease (n = 311) were interviewed using structured questions concerning the presence of unmet needs. The six need scales represented two dimensions: needs referring to physical functioning and needs referring to psychosocial well-being. However, considerable differences were found in the amount of formal and informal care and in the presence of unmet needs between the need scales constituting one dimension. Indications for construct validity were found for five out of six need categories. The results show that, when evaluating home health care, the full range of needs has to be considered and the presence of unmet needs can be used as an indicator of the quality of home health care.