Application of a new municipal management model of home care service in Barcelona: Assessment of workers’ labour conditions, health, and well-being

Article type: Research Article

Authors: Ollé-Espluga, Laia^{a; b; *} | Vargas-Leguas, Hernán^{a; 1} | Torrens Mèlich, Lluís^{c; d; 2} | Juan Serra, Marta^{c; 3} | Arcas, Maria Marta^{a; b; e; 4} | Cortès-Franch, Imma^{a; b; f; g; 5}

Affiliations: [a] Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain | [b] Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain | [c] Directorate for Social Innovation, Area of Social Rights, Global Justice, Feminisms and LGTBI, Barcelona City Council, Barcelona, Spain | [d] Secretary of Social Affairs and Families, Generalitat de Catalunya, Barcelona, Spain | [e] Servei de Qualitat, Docència i Recerca, Fundació Sanitària Mollet, Mollet del Vallès, Barcelona, Spain | [f] Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain | [g] Universitat Pompeu Fabra, Barcelona, Spain

Correspondence: [*] Address for correspondence: Laia Ollé-Espluga. E-mail: lolle@aspb.cat; ORCID: 0000-0001-8943-6625.

Note: [1] ORCID: 0000-0002-5517-0360.

Note: [2] ORCID: 0000-0002-7354-1233.

Note: [3] ORCID: 0009-0007-8558-7865.

Note: [4] ORCID: 0000-0001-7814-0896.

Note: [5] ORCID: 0000-0002-1244-9652.

Abstract: BACKGROUND:In 2018, Barcelona City Council implemented a pilot phase of an organisational change in the municipal home care service (HCS) system. Inspired by the Buurtzorg model, the new model promotes the creation of self-managing teams operating in a restricted community setting. OBJECTIVE:To assess the pilot phase of the new model, focusing on employees’ working and employment conditions as well as on their health and well-being outcomes. METHODS:Mixed-methods impact evaluation. First, a quantitative evaluation was conducted between October 2018 and October 2020, using a pre-post study design with one pretest and two posttest measurements in an intervention and a comparison group. The intervention group was composed of the members of the work teams implemented in the pilot phase from October 2018 onwards (baseline n = 44). The comparison group consisted of workers from the same districts working under the usual HCS system (baseline n = 72). Next, a qualitative study was conducted in workers from the intervention group in winter 2021–2022 (n = 10). RESULTS:The pre-post study results yielded positive changes for the intervention group in social support and autonomy, as well as in many of the employment conditions. This group also experienced increases in psychological demands, painful positions, fatigue and psychological distress. Two main themes affecting workers’ well-being emerged from the interviews: factors inherent to the self-management model and external factors. CONCLUSIONS:Health and well-being outcomes seem to depend on the balance between job demands, resources, and ways of channelling conflicts within teams.

Keywords: Home care services, self-organising teams, employment conditions, working conditions, health, evaluation study

DOI: 10.3233/WOR-230668

Journal: Work, vol. 79, no. 4, pp. 1909-1924, 2024