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Rosenblum S, Meyer S, Richardson A, Hassin-Baer S. Early identification of subjective cognitive functional decline among patients with Parkinson's disease: a longitudinal pilot study. Sci Rep 2022; 12:22242. [PMID: 36564494 PMCID: PMC9789081 DOI: 10.1038/s41598-022-26280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022] Open
Abstract
Practical methods for early identification of Parkinson's disease (PD) mild cognitive impairment (PD-MCI) through changes in real-life daily functioning are scarce. The aim of the study was to examine whether the cognitive functional (CF) feature, comprising of seven self-reported Movement Disorder Society's (MDS) Unified Parkinson's Disease Rating Scale (UPDRS) items, predicts PD patients' cognitive functional status after a year. We conducted a 1-year follow-up of 34 PD patients (50-78 year; 70.6% men) suspected of MCI using the following measures: the MDS-UPDRS, UPDRS-CF feature, Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Parkinson's Disease Cognitive Functional Rating Scale (PD-CFRS), and Daily Living Questionnaire (DLQ). The first and second UPDRS-CF feature scores, and additional measures at the 1-year follow-up significantly correlated. Hierarchical regression revealed that the initial MoCA, TMT, and BDI scores predicted the second UPDRS-CF, and the first UPDRS-CF predicted 31% of the second PD-CFRS score variance. Depression moderated the relationship between the first UPDRS-CF score and the DLQ Part A. These results suggest practical, self-reported, daily functional markers for identifying gradual decline in PD patients. They consider the patients' heterogeneity, underlying cognitive pathology, and implications on daily functioning, health, and well-being.
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Affiliation(s)
- Sara Rosenblum
- grid.18098.380000 0004 1937 0562Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, 3498838 Israel
| | - Sonya Meyer
- grid.411434.70000 0000 9824 6981Department of Occupational Therapy, Ariel University, Ariel, 4077603 Israel
| | - Ariella Richardson
- grid.419646.80000 0001 0040 8485Department of Industrial Engineering, Jerusalem College of Technology, Jerusalem, 9372115 Israel
| | - Sharon Hassin-Baer
- grid.413795.d0000 0001 2107 2845Movement Disorders Institute, Sheba Medical Centre, Ramat-Gan, 5262000 Israel ,grid.413795.d0000 0001 2107 2845Department of Neurology, Sheba Medical Centre, Ramat-Gan, 5262000 Israel ,grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801 Israel
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Fadayevatan R, Rahimi M, Abedi H. Care Process in Iranian Nursing Homes: A Grounded Theory Study. J Caring Sci 2021; 10:160-168. [PMID: 34849360 PMCID: PMC8609117 DOI: 10.34172/jcs.2021.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/02/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: The need and use of long-term care services for older people has increased with their rising population and there is little information about the state of serving in nursing homes. This study aimed to identify the caring process in Iranian nursing homes.
Methods: This qualitative study was conducted in three Iranian nursing homes using grounded theory approach. The participants included 28 individuals (14 older people and 14 caregivers). The data were collected using unstructured interviews up to data saturation, and analyzed by constant comparative method.
Results: Fragmented care emerged as the core variable. The main factor for developing the core variable was ‘experience-based caring’. Other factors included ‘inappropriate structure for care’ as contextual factors in the nursing homes environment and ‘keeping instead of caring’, ‘dismal life’, and ‘up and down of the path’ as strategies and consequences.
Conclusions: The most common type of care was the routine and unplanned one with focusing on physical aspects. To improve a delivery care system for older people in nursing homes, proposing a care plan with focus on an integrated model of care in nursing homes, provision of instructions for treatment, as well as supervision and training caregivers to provide better care are necessary
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Affiliation(s)
- Reza Fadayevatan
- Department of Gerontology, Iranian Research Center of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Majid Rahimi
- Department of Health Education and Promotion, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Heidarali Abedi
- Department of Nursing, Isfahan Branch, Islamic Azad University, Khorasghan, Iran
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Park I, Lee K, Yim E, Noh K. Differences in Function and Healthcare Cost of Older Adults with Dementia by Long-Term Care Service Type: A National Dataset Analysis. Healthcare (Basel) 2021; 9:healthcare9030307. [PMID: 33802027 PMCID: PMC8000297 DOI: 10.3390/healthcare9030307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/18/2021] [Accepted: 03/06/2021] [Indexed: 11/16/2022] Open
Abstract
This study aims to analyze the function and cost changes among long-term care insurance (LTCI) beneficiaries with low-severity dementia according to their LTCI service type. Data were collected from the Korean LTCI and national health insurance (NHI) datasets. Participants were 4414 beneficiaries with dementia aged 65 or older who received LTC services continuously for 4 years (2008–2011). LTCI service types were classified into home care (HC), institutional care (IC), and combined care (CC). Activities of daily living (ADL), cognitive function, medical cost, and benefit-cost were assessed. Linear mixed models and multiple regression models were used to analyze the changes in function and costs of the beneficiaries. ADL, cognitive function, medical cost, and benefit-cost differed significantly depending on the service type and time (p < 0.001). LTCI service types affected the degree of changes in ADL, cognitive function, medical cost, and benefit-cost over four years and showed negative changes in IC and CC beneficiaries than HC beneficiaries. HC is a cost-effective way to maintain the function of beneficiaries with low-severity dementia. Thus, efforts are needed to actively promote HC services.
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Affiliation(s)
- Ilsu Park
- Department of Healthcare Management, Dong-eui University, 176 Eomgwangno, Busanjin-gu, Busan 47340, Korea;
| | - Kyounga Lee
- Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea
- Correspondence:
| | - Eunshil Yim
- Department of Nursing, Daegu Health College, 15 Yeongsong-ro, Buk-gu, Daegu 41453, Korea;
| | - Kyunghee Noh
- Mokpo National Quarantine Station, 20 Haean-ro, 177 Beon-gil, Mokpo-si 58754, Korea;
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Nurses' culturally mediated practices influencing pain care provision for older people in acute care: Ethnographic study. Appl Nurs Res 2019; 48:22-29. [DOI: 10.1016/j.apnr.2019.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/07/2019] [Accepted: 05/07/2019] [Indexed: 11/23/2022]
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Meranius S, Karin J. Management Practices Promoting Sustained Implementation of the Quality Register Senior Alert for Older Adults in Municipal Care in Sweden. Open Nurs J 2018; 12:215-224. [PMID: 30505372 PMCID: PMC6210526 DOI: 10.2174/1874434601812010215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 08/24/2018] [Accepted: 09/23/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Senior Alert is a national quality register aimed at supporting a standardized, structured, and systematic preventive care process for adults aged 65 and over in the areas malnutrition, pressure ulcers, falls, problems with oral health and bladder dysfunction. Therefore, the quality register is particularly suitable for older adults with multimorbidity. Aim: The aim was to describe management practices that contributed to the sustained implementation of the quality register Senior Alert in municipal elderly care in Sweden. Methods: The design of this pilot study was descriptive and inductive. The sample of n = 12 included managers (n = 7) and care staff (n = 5) at seven municipal care homes for older adults in Sweden. The study was performed between April 2014 and June 2014 using two methods: Individual interviews and nonparticipant unstructured observations. Data were analyzed using qualitative content analysis. Results: The analysis led to the following generic categories: leading teamwork, leading a preventive care process and leading a supportive organizational structure, and to one main category: management promoting learning and quality improvement. Conclusion: To be sustainable, Senior Alert implementations in municipal elderly care need management. Management, by leading teamwork, a preventive care process and a supportive organizational structure, is essential for achieving learning and quality improvement.
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Affiliation(s)
- Summer Meranius
- School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Josefsson Karin
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Höglander J, Eklund JH, Eide H, Holmström IK, Sundler AJ. Registered Nurses' and nurse assistants' responses to older persons' expressions of emotional needs in home care. J Adv Nurs 2017; 73:2923-2932. [PMID: 28586520 DOI: 10.1111/jan.13356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/11/2017] [Accepted: 05/23/2017] [Indexed: 01/12/2023]
Abstract
AIM This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits. BACKGROUND Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs. DESIGN Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care. METHODS Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). RESULTS The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice. CONCLUSION The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.
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Affiliation(s)
- Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | | | - Hilde Eide
- Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Algilani S, Langius-Eklöf A, Kihlgren A, Blomberg K. An interactive ICT platform for early assessment and management of patient-reported concerns among older adults living in ordinary housing - development and feasibility. J Clin Nurs 2017; 26:1575-1583. [PMID: 27381423 DOI: 10.1111/jocn.13468] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To develop and test feasibility and acceptability of an interactive ICT platform integrated in a tablet for collecting and managing patient-reported concerns of older adults in home care. BACKGROUND Using different ICT applications, for example interactive tablets for self-assessment of health and health issues based on health monitoring as well as other somatic and psychiatric monitoring systems may improve quality of life, staff and patient communication and feelings of being reassured. The European Commission hypothesises that introduction of ICT applications to the older population will enable improved health. However, evidence-based and user-based applications are scarce. DESIGN The design is underpinned by the Medical Research Council's complex intervention evaluation framework. A mixed-method approach was used combining interviews with older adults and healthcare professionals, and logged quantitative data. METHODS In cooperation with a health management company, a platform operated by an interactive application for reporting and managing health-related problems in real time was developed. Eight older adults receiving home care were recruited to test feasibility. They were equipped with the application and reported three times weekly over four weeks, and afterwards interviewed about their experiences. Three nurses caring for them were interviewed. The logged data were extracted as a coded file. RESULTS The older adults reported as instructed, in total 107 reports (Mean 13). The most frequent concerns were pain, fatigue and dizziness. The older adults experienced the application as meaningful with overall positive effects as well as potential benefits for the nurses involved. CONCLUSIONS The overall findings in this study indicated high feasibility among older adults using the ICT platform. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations. RELEVANCE TO CLINICAL PRACTICE An ICT platform increased the older adults' perception of involvement and facilitated communication between the patient and nurses.
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Affiliation(s)
- Samal Algilani
- Nutrition and Physical Activity Research Centre (NUPARC), Faculty of Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Annica Kihlgren
- Nutrition and Physical Activity Research Centre (NUPARC), Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Rahimi M, Fadayevatan R, Abedi HA. Care Instability in Nursing Homes; A Qualitative Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e21515. [PMID: 27186382 PMCID: PMC4867158 DOI: 10.5812/ircmj.21515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 08/10/2014] [Accepted: 09/01/2014] [Indexed: 11/16/2022]
Abstract
Background: The use of long-term care services has risen and this trend is expected to continue as the population reaches old age. Objectives: This study was performed to assess the caring conditions in nursing homes. Patients and Methods: This study was conducted with a qualitative approach using conventional qualitative content analysis. The study was conducted on 23 Iranian participants including 14 elders and 9 caregivers. Data was collected with unstructured interviews and continued to the point of data saturation. Analysis of data was performed continually and concurrently with data collection through a comparative method. Results: Three themes emerged from 595 open codes including care as unpleasant task, sustained care and insufficient resources. Ten subthemes indicated participants’ experiences and understanding of caring conditions in a nursing home. Conclusions: The prevailing given care was the routine one with a focus on physical aspects, although there was some psychological care given to the older people. The findings of this research are guidelines for managers and care planners in nursing homes who should pay attention to physical and psychological care needs of older people. In addition, it is important to pay close attention to the needs of caregivers and provision of instructions for treatment, supervision and education of caregivers and medical students to provide a better care.
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Affiliation(s)
- Majid Rahimi
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Reza Fadayevatan
- Iranian Research Center of Aging, Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
- Corresponding Author: Reza Fadayevatan, Iranian Research Center of Aging, Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel: +98-2122180004, E-mail:
| | - Heidar Ali Abedi
- Department of Nursing Midwifery, Islamic Azad University, Isfahan Branch, Khorasghan, IR Iran
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Dellaroza MSG, Pimenta CADM, Lebrão ML, Duarte YA. [Association of chronic pain with the use of health care services by older adults in Sao Paulo]. Rev Saude Publica 2014; 47:914-22. [PMID: 24626496 DOI: 10.1590/s0034-8910.2013047004427] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 06/02/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate the association between use of health care services by older adults with chronic pain and sociodemographic and health variables. METHODS Cross-sectional study whose population sample of 1,271 older adults with chronic pain and with no cognitive deficit was obtained through home surveys in Sao Paulo, SP, Southeastern Brazil,, in 2006. The study considered pain lasting for six or more months as chronic. The criterion for health care service use was more than four doctor appointments or having been admitted to a hospital during the past year. For those in chronic pain for at least one year, the existence of an association between the use of health care services and independent variables (pain and socio-demographical characteristics and self-reported morbidities) was tested using univariate (RaoScott test of association) and multivariate analysis (Cox Multiple Regression with robust variance). Stata 11.0 was used for the statistical analysis, and the significance level adopted was p < 0.05. RESULTS The prevalence of health care service use among older people with pain was 48,0% (95%CI 35.1;52.8) and did not differ from older adults without chronic pain (50.5%, 95%CI 45.1;55.9). The multivariate analysis showed that the chance of using health care services was 33,0% lower for older adults with pain for more than two years than those with pain between one and two years (p = 0.002). The chance was 55,0% higher for those with intense pain (p = 0.003) and 45,0% higher for those with moderate pain interference in the work (p = 0.015). CONCLUSIONS Chronic pain was found to be common and was associated with negative effects on independence and mobility. More intense and recent chronic pain that affected work resulted in greater use of health care services.
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Hedman AMR, Fonad E, Sandmark H. Older people living at home: associations between falls and health complaints in men and women. J Clin Nurs 2013; 22:2945-52. [DOI: 10.1111/jocn.12279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - Edit Fonad
- Department of Neurobiology; Karolinska Institutet; Care Sciences and Society; Stockholm Sweden
| | - Hélène Sandmark
- School of Health; Mälardalen University; Care and Social Welfare, Public Health Sciences; Västerås Sweden
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Stolt M, Suhonen R, Puukka P, Viitanen M, Voutilainen P, Leino-Kilpi H. Development process and psychometric testing of foot health assessment instrument. J Clin Nurs 2013; 22:1310-21. [DOI: 10.1111/jocn.12078] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Minna Stolt
- Finnish Doctoral Programme in Nursing Science; Department of Nursing Science; University of Turku; Turku Finland
| | - Riitta Suhonen
- Department of Nursing Science; University of Turku; Turku Finland
| | - Pauli Puukka
- National Institute for Health and Welfare Turku; Turku Finland
| | - Matti Viitanen
- Department of Geriatrics; University of Turku; Turku Finland
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Sundsli K, Söderhamn U, Espnes GA, Söderhamn O. Ability for self-care in urban living older people in southern Norway. J Multidiscip Healthc 2012; 5:85-95. [PMID: 22536079 PMCID: PMC3333801 DOI: 10.2147/jmdh.s29388] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people’s health and ways of living in a self-care environment, with special regard to health promotion. Aim The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health, being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion Health professionals should focus on the health-promoting factors that reinforce older people’s ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person’s self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens.
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Affiliation(s)
- Kari Sundsli
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, Norway
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Condelius A, Hallberg IR, Jakobsson U. Hospital and outpatient clinic utilization among older people in the 3-5 years following the initiation of continuing care: a longitudinal cohort study. BMC Health Serv Res 2011; 11:136. [PMID: 21627791 PMCID: PMC3133543 DOI: 10.1186/1472-6963-11-136] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 05/31/2011] [Indexed: 11/28/2022] Open
Abstract
Background Few studies have investigated the subsequent rate of hospital and outpatient clinic utilization in those who receive continuing care and have documented frequent usage over one year. Such knowledge may be helpful in identifying those who would benefit from preventive interventions. The aim of this study was to investigate and compare the subsequent rate of hospital and outpatient clinic utilization among older people with 0, 1, 2, 3 or more hospital stays in the first year following the initiation of continuing care. A further aim was to compare these groups regarding demographic data, health complaints, functional and cognitive ability, informal care and mortality. Methods A total of 1079 people, aged 65 years or older, who received a decision regarding the initiation of continuing care during the years 2001, 2002 or 2003 were investigated. Four groups were created based on whether they had 0, 1, 2 or ≥3 hospital stays in the first year following the initiation of continuing care and were investigated regarding the rate of hospital and outpatient clinic utilization in the subsequent 3-5 years. Results Fifty seven percent of the sample had no hospital stay during the first year following the initiation of continuing care, 20% had 1 stay, 10% had 2 stays and 13% had three or more hospital stays (range: 3-13). Those with ≥3 hospital stays in the first year continued to have the significantly highest rate of hospital and outpatient care utilization in the subsequent years. This group accounted for 57% of hospital stays in the first year, 27% in the second year and 18% in the third year. In this group the risk of having ≥3 hospital stays in the second year was 27% and 12% in the third year. Conclusions There is a clear need for interventions targeted on prevention of frequent hospital and outpatient clinic utilization among those who are high users of hospital care in the first year after the initiation of continuing care. Perhaps an increased availability of medically skilled staff in the day to day care of these people in the municipalities could prevent frequent hospital and outpatient clinic utilization, especially hospital readmissions.
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Affiliation(s)
- Anna Condelius
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
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