Developing a Comprehensive Model of Home-Based Long-Term Care for Older People in Iran: A Multi-Method Study

Introduction : With the increasing aging population, the demand for care that fosters independence in older adults is rising. Complications from hospitalization and the preference for aging in place highlight the need for geriatric home care systems. This study aims to develop a comprehensive home-based care model specifically for Iranian seniors and evaluate its feasibility. Methods This study employed a multi-phase approach in Iran. It began with a mixed-methods analysis, including a survey on caregiver reliance followed by qualitative interviews to identify challenges in home care services. Phase 2 involved a scoping review of home care frameworks from various countries. In Phase 3, an initial model was created based on previous findings and relevant documents in Iran. In the fourth phase, feedback was gathered from an expert panel selected through purposive sampling, with discussions recorded and concluding at saturation. The feedback was then integrated into the final model. Additionally, in a Delphi study, experts evaluated the model components using a four-point Likert scale, calculating the content validity index (CVI) for each item, where a CVI of 79% or higher indicated validity, and continuous feedback led to iterative refinements. Results Following the design of the initial model, an expert panel convened with 15 participants to review the framework. The final model comprises seven key components: leadership & governance, legislative framework, financial framework, human resource management system, information management system, and control & monitoring system. Results from the Delphi study indicated that with a CVI exceeding 80%, this model is deemed a valid framework for delivering home-based care. Conclusion This study presents a comprehensive model that serves as a valuable guide for policymakers seeking to implement integrated home care with professional oversight. By doing so, it aims to enhance the quality of care and improve stakeholder satisfaction.