ABSTRACT
A long-term home care program was required because patients had proved they were unable to manage independently. Visiting nursing's traditional care for long-term home care patients was removal from "back bed-rooms of relatives," but in a time-limited and economical manner. The emphasis of the Philadelphia Home Care Plan (PHCP) on long-term patients was a departure from established home nursing programs. The Philadelphia visiting nurse agencies (VNS) had difficulty sustaining services to long-term patients, even when they were physically dependent on VNS nursing care. The increasing prevalence of long-term illness prompted Philadelphia's social planners of the late 1930s to anticipate demand for new health services, but their efforts were interrupted by World War II. The Philadelphia Visiting Nurse Society established the PHCP in April 1949. Potential economic conflict between coordinated home care programs (CHCP) physicians and private physicians meant that CHCPs had to be concerned with program acceptance by local private physicians.
