therefore, are by definition front office activities. This will facilitate on-going interaction
between professional and client, thereby providing the opportunity to adapt the elderly
client’s care and service package when needed.
However, the elderly client does not have to be involved in all activities required to set
up the appropriate care and service package. Some activities, such as administration
of client data or checking the care and service package against financial regulations
can take place behind the scenes. These, so-called, back office activities are suited for
standardized processing of large amounts of data, thereby offering efficiency potential
to the HWC service providers.
Overall, modular production principles will allow conceptually HWC service providers
to put demand-based care into practice. Modularity seems to be particularly useful in
providing choice options, variation and joint provision of care and service
packages,
whereas supporting front office-back office conditions seem to promote client
interaction in HWC service supply. Furthermore, both concepts would avoid a rise
in costs, something that is very desirable in HWC service provision.
The proposed applicability of modular production is based on the indirect assumption
that, with all their diversity, elderly clients are still sufficiently alike for modularity
to work. Although elderly clients all are unique individuals, we have already pointed
out that overlap can be found in the needs and demands of elderly clients (Luijkx et
al., 2004, Luijkx and Pardoel, 2005, Luijkx and De Blok, 2007). Besides, research has
revealed packages in HWC service combinations that elderly clients actually acquire
(Schellingerhout, 2008). Because of these analogies among elderly clients, providers
of HWC services can indeed make use of a modular set-up of care and services, at
least for those categories of needs and wants that overlap within, or among, segments
of the elderly population. Through seamless combination of standard components
in packages,
advantages in cost, time and quality can be gained (Bohmer, 2005). The
resources gained can, in turn, be deployed to those dimensions of needs which are
too complex or distinctive to address with standardized modules and components.
Modularity, thereby initiates blending of standard and custom care and service
provision by addressing those dimensions in which groups of clients have the same
needs with standardized components, while leaving room for the natural heterogeneity
of elderly clients (Bohmer, 2005).
2.6 Conclusion
The previous sections have shown the ability of modular production principles to
deal with the highly diverse needs of elderly clients, thereby enhancing the provision
of demand-based HWC service packages. The concept enables approaching the
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emand-based pr
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Chapt
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operational implications of demand-based care and putting client demand at the centre
of HWC service provision. As such, modularity, when properly adapted to a service
setting, has high potential to close the gap between policy and practice that current
literature on demand-based care has not been able to solve so far. The recognition of
the potential of this concept is an important first step in elaborating demand-based care
and service provision to the operational level. This makes our insights of significant
relevance to both policy makers and practitioners.
Our findings, however, are largely based on theory, so highly conceptual in nature, and
at this time can be supported merely on the basis of intuitive appeal and experience
rather than by empirical research. This makes our application of modularity and
front office–back office configurations in HWC service provision to elderly clients
living independently simplified. Furthermore, we are aware that we have left out
social aspects of demand-based care, such as having the right attitude towards and
respect for the client. Although we recognize the importance of the relational and
emotional characteristics of demand-based care, we chose to focus only on operational
characteristics. However, we opened up a working language and point of departure
for studying the elaboration of demand-based concepts in an HWC context. From
this starting point, additional research needs to be executed, both conceptually and
empirically in order to further close the gap between policy intent and the daily practice
of demand-based care and service provision. In this sense, interesting questions for
investigation could be:
What are the optimal basis, scale, amount and level of detail for the
development of components and modules in HWC services from a
client point-of-view?
How should the professional be included as an integral part of a modular
care and service architecture?
What requirements need to be present in the operational organisation
to ensure the HWC service package can be delivered at any time, in any
place and in any combination demanded?
And, when taking a general systems view, how to align the construction
of HWC service packages with the Dutch HWC system’s financing
structure?
Addressing these research questions will provide useful theoretical guidance to advance
practice and will ultimately lead to the provision of demand-based care and services
in the daily routines of HWC service organizations.
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Modular
Care Provision