Effectiveness of a health and social care integration programme for home-dwelling frail older persons in Argentina
| Autor: | Gastón Perman, Leonardo Garfi, Mariana Alejandra Prevettoni, Roxana Elizabeth Ramos, Lucila Hornstein, Verónica Martínez Infantino, Marcelo Schapira, Cristian Gallo, Silvana María Scozzafava, Javier Saimovici, María Florencia Cunha Ferré, Tami Guenzelovich |
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| Rok vydání: | 2021 |
| Předmět: |
Gerontology
Health (social science) Sociology and Political Science Leadership and Management 030503 health policy & services Health Policy Home dwelling Integrated care 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Social care 030212 general & internal medicine 0305 other medical science Psychology |
| Zdroj: | International Journal of Integrated Care; Vol 22: ICIC21 Virtual Conference 2021; 190 |
| ISSN: | 2053-4353 2053-4345 1568-4156 |
| Popis: | Introduction The evidence of effectiveness of integrated care initiatives for home-dwelling frail older persons is still inconclusive. There is a need for more studies, especially in developing countries. Our objective was to assess the effectiveness of a health and social care integration programme versus the best standard of care to date in this population.Theory/MethodsQuasi-experimental study performed in patients' homes in Buenos Aires, Argentina. The intervention arm had a health and social care counsellor that systematically reviewed the social and biological situation following a structured process, evaluating: functionality, nutrition, mobility, pain, cognition, medication reconciliation and adherence, need for care, quality of care, and environmental safety. The control group received the best standard of care to date, with access to the same health or social care services, but without the counsellor and related processes. The main outcome was the adjusted hazard ratio for hospitalizations after one year using a Cox-proportional hazards model.ResultsWe recruited 121 persons in each group. The crude hazard ratio for hospital admissions, comparing the intervention to the control group was 0.622 (95% CI 0.427 to 0.904; p 0.013). The adjusted hazard ratio (aHR) was 0.503 (95%CI 0.340 to 0.746; p 0.001). The aHR for death was 0.993 (95%CI 0.492 - 2.002; p 0.984). The absolute difference in the quality of life was 16.59 points (95%CI 12.03 to 21.14; p |
| Databáze: | OpenAIRE |
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