Financing of volunteer-based care assistance in hospitals, wishful thinking or feasible?

Introduction: One of the main problems in healthcare is communication. A solution for the communication problem may be found in volunteer-based care assistance. Examples in this research are the patient advocate, the expert patient and the co-patient. These innovations are compared with the use of paid assistants as the patient coach and the case manager. The financing of especially these types of innovations however, can be difficult. Occassion:The willingness of actors to finance and take responsibility for volunteer-based care assistance can be influenced by frames which determine how these innovations are viewed. Furthermore, the financing options may not be fitting for volunteer-based care assistance. Methods: The objective is 1) to find out how financing can take place and 2) who will be responsible for the financing. The main question is: In what way can volunteer-based care assistance intended to improve the treatment of patients be funded within the Dutch hospitals and what is the role of the different actors involved? In this research a combination of literature research and qualitative research was applied. In total, 16 interviews were held, while 19 actors refused to participate. Results: Framing is an important but undervalued aspect which influences financing. Tasks of volunteers are mainly seen as wellness related, not as care related. Framing is the reason that the criteria for financing of care related innovations as volunteer-based care assistance are more complicated compared to those of wellness related innovations as delivering books to patients. Furthermore, framing determines which financing options are feasible and which actors can take responsibility for financing. Structural financing however is more difficult than pilot financing for both types of innovations. Next to framing, the healthcare system is an imitating factor because mainly performances of professionals are paid and not the total care process. The healthcare system complicates the idea of funding, but also the feasibility of certain financing options, as for example the insurance package, for these innovations. Discussion Scientific recommendations are to interview more actors and (other) experiences with volunteer-based care assistance in practice, to investigate other aspects which could influence financing but also the options for changes in the (current) healthcare system. Practical recommendations for involved foundations are gaining evidence, approaching more actors for stimulating financing and using the knowledge about framing as an advantage. Conclusion: For the financing of volunteer-based care assistance are many options available. Many actors influence (taking responsibility for) financing, of which the healthcare system and framing most important are. Finding financing and responsible actors is therefore more difficult, but certainly not impossible.