JMIR Publications

ABSTRACT

Background:

Various forms of welfare technologies are often described as the solution to the increasing pressure on primary health care services and are advocated by central government and policy throughout the Western world. However, there is a knowledge gap concerning whether local governments (i.e., municipalities) respond to the call for technology innovations.

Objective:

1) Describe what types and to what the extent welfare technology is provided in long-term care (i.e., nursing homes and home care services). 2) Examine whether the extent of welfare technology provision differs based on municipal characteristics (population size, centrality, the proportion of older inhabitants, and economy). 3) Identify how the municipalities describe their efforts toward integrating welfare technologies in long-term care.

Methods:

This is a cross-sectional study of survey data. Representatives from all of Norway’s 422 municipalities (one per municipality) were invited to answer the survey from February to April 2019. The frequencies describe the distribution of types and the extent of welfare technologies, while a Fisher’s exact and Kruskal-Wallis one-way ANOVA were used to test the association between the extent of welfare technology and municipal characteristics. The free-form text data were analyzed using a thematic analysis.

Results:

In total, 277 municipalities completed the survey. Technology for safety was the most widespread type of welfare technology (96% in home care services, 82% in nursing homes). Technology for social contact was least prevalent. Two-thirds reported providing one or two different types of welfare technology. There was a statistically significant association between the extent of welfare technology and population size (P=.01 in both nursing home ad homecare service), centrality (P=.01 for nursing home and P<.001 for homecare services), and municipal economy (P=.02 in nursing home and P=<.001 in homecare service). The extent of welfare technology was not associated with the proportion of older adults (P =.33 in nursing homes and P =.50 in homecare services). The municipalities described being in a project and piloting phase, committing to future investment in more technology. Monetary resources were allocated, and they were investing in competency development among staff while being concerned about establishing collaborations within the municipality and between municipalities. Homecare services seem to have a more person-centered approach, while nursing homes seem to have a more technology-centered approach.

Conclusions:

Many municipalities provide welfare technologies, and most provide safety technologies. However, the extent is limited and varies by municipal characteristics. The municipalities appeared committed toward investing in and integrating welfare technologies, both in relation to economic and personal recourses. However, their practice has so far been dominated by piloting, and welfare technologies do not seem fully integrated into long-term care services. Welfare technology innovation appears somewhat top-down but also concerned with creating a “window of opportunity.”