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Progress Toward Long-Term Care Protection in Latin America: A National Long-Term Care System in Costa Rica. J Am Med Dir Assoc 2021; 23:266-271. [PMID: 34270952 DOI: 10.1016/j.jamda.2021.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 11/20/2022]
Abstract
The aging of the world's population is a reality. People are living longer, not just in high-income countries, but it remains unclear whether their extra years will be lived in better health. In fact, an increasing number of older adults will probably require help to perform activities of daily living. Within the framework of its Global Strategy and Action Plan on Ageing and Health, the World Health Organization has called on all countries to create suitable and equitable long-term care systems that meet the needs of older people. The challenge is particularly acute in Latin America. The region is aging faster than other areas in the world, and its less-prepared social protection systems suffer from limited economic resources. Costa Rica is one the first middle-income countries to create a national long-term care system. This article describes the main characteristics of this system and discusses it from an international perspective. The results show that it has been designed to prioritize severity of dependency and cost containment, and to reinforce the formalization of care. The outcome of its implementation will affect the decisions of neighboring countries and those with similar economic conditions concerning the development of their own long-term care systems.
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Alexander GL, Georgiou A, Doughty K, Hornblow A, Livingstone A, Dougherty M, Jacobs S, Fisk MJ. Advancing health information technology roadmaps in long term care. Int J Med Inform 2020; 136:104088. [PMID: 32120318 DOI: 10.1016/j.ijmedinf.2020.104088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/11/2019] [Accepted: 01/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Our purpose is to provide evidence that health information technology should be a mainstay of all future health and social support services for older people globally, both within and across community and residential care services. METHODS This work was conducted in two phases. In phase I, the authors conducted a focused exploration by selecting a convenience sample of four long term care health information technology roadmaps, developed by members of four different long term care health information technology collaboratives in United States, Australia, United Kingdom, and New Zealand. During Phase II the research team carried out an extensive systematic review of existing literature sources (2000-2018) to support roadmap assumptions. RESULTS Using converging domains and content, we offer recommendations among five aged care roadmap domains: Strategy/Vision, Continuing Care Community, Services and Support Provided, External Clinical Support, and Administrative. Within these domains we provide recommendations in five content areas: Innovation, Policy, Evaluation, Delivery Systems and Human Resources. We recommend future strategies for LTC HIT roadmaps that include 61 emphasis areas in aged care in these content areas and domains. CONCLUSIONS The roadmap provides a navigation tool for LTC leaders to take a strategic and comprehensive approach as they harness the potential of health information technologies to address the challenges and opportunities of LTC in the future.
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Affiliation(s)
- Gregory L Alexander
- University of Missouri, Sinclair School of Nursing S415, Columbia, MO 65211.
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, NSW Australia 2109.
| | - Kevin Doughty
- Director at i-Centre for Usable Home Technology, Caernarfon, Gwynedd United Kingdom.
| | | | - Anne Livingstone
- Research and Development Lead, Global Community Resourcing, 1/747 Lytton Road, Murarrie, QLD 4172.
| | - Michelle Dougherty
- Sr. Health Informatics Research Scientist, RTI International, Digital Health Policy & Standards.
| | - Stephen Jacobs
- Senior Lecturer, The School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92-019, Auckland Mail Centre, Auckland NZ 1142.
| | - Malcolm J Fisk
- Senior Research Fellow, Centre for Computing and Social Responsibility, De Montfort University, Leicester., Director, Telehealth Quality Group EEIG.
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Zimmerman S, Sloane PD. JAMDA's New Editors-in-Chief Present a Vision for the Journal of Post-Acute and Long-Term Care Medicine. J Am Med Dir Assoc 2017; 19:1-3. [PMID: 29191766 DOI: 10.1016/j.jamda.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC; Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Philip D Sloane
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Yamada Y, Nanri H, Watanabe Y, Yoshida T, Yokoyama K, Itoi A, Date H, Yamaguchi M, Miyake M, Yamagata E, Tamiya H, Nishimura M, Fujibayashi M, Ebine N, Yoshida M, Kikutani T, Yoshimura E, Ishikawa-Takata K, Yamada M, Nakaya T, Yoshinaka Y, Fujiwara Y, Arai H, Kimura M. Prevalence of Frailty Assessed by Fried and Kihon Checklist Indexes in a Prospective Cohort Study: Design and Demographics of the Kyoto-Kameoka Longitudinal Study. J Am Med Dir Assoc 2017; 18:733.e7-733.e15. [PMID: 28501417 DOI: 10.1016/j.jamda.2017.02.022] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/28/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The Kyoto-Kameoka Study was launched in 2011-2012 to identify the associations among food intake, nutritional status, physical activity, oral function, quality of life or social capital, the use of long-term care insurance (LTCI) system, and healthy lifespan in community-dwelling older people as a part of the World Health Organization Safe Community program. DESIGN A prospective cohort study, reporting baseline demographics (cross-sectional data). SETTING AND PARTICIPANTS We conducted 2 mailed self-administered questionnaire surveys; one is a complete population survey with a comprehensive survey of needs in the sphere of daily life (NSDL) that included 2 different frailty indexes, the Kihon Checklist (KCL) and the Fried phenotype, socioeconomic status, general and psychological health, and social relationships; followed by the more detailed Health and Nutrition Survey. A slightly modified NSDL survey was conducted again in 2013. Survival time, LTCI certification, and medical and long-term care costs after the baseline survey will be followed. RESULTS Of 18,231 NSDL questionnaires distributed, 13,294 people responded (response rate: 72.92%; mean age 73.7 ± 6.4 and 75.1 ± 7.2 years for men and women, respectively; 12,054 people without and 1240 with LTCI certification). In people without LTCI, the proportion of robust, prefrail, and frail were 30.3%, 59.8%, and 9.9% in men and 25.3%, 64.7%, and 10.0% in women, according to the Fried index. The proportion of frail people as defined by KCL ≥7 was 30.8% in men and 33.3% in women. CONCLUSIONS The study is the first to document frailty prevalence using both Fried and KCL measures with a complete city population survey among older Japanese in the community as a part of World Health Organization Safe Community program. The study is expected to provide valuable evidence of the effects of lifestyle habits on long-term care prevention and healthy life span.
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Affiliation(s)
- Yosuke Yamada
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
| | - Hinako Nanri
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yuya Watanabe
- Faculty of Health and Sports Science, Doshisha Unviersity, Kyotanabe, Japan
| | - Tsukasa Yoshida
- Graduate School of Science and Technology, Kyoto Institute of Technology, Kyoto, Japan; Senior Citizens' Welfare Section, Kameoka City Government, Kameoka, Japan
| | - Keiichi Yokoyama
- Department of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Aya Itoi
- Department of Health, Sports and Nutrition, Kobe Women's University, Kobe, Japan
| | - Heiwa Date
- Faculty of Data Science, Shiga University, Hikone, Japan
| | - Miwa Yamaguchi
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Hajime Tamiya
- Nikko Medical Center, Dokkyo Medical University, Nikko, Japan
| | | | - Mami Fujibayashi
- Division of Physical and Health Education, Setsunan University, Osaka, Japan
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha Unviersity, Kyotanabe, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University, Tokyo, Japan
| | - Eiichi Yoshimura
- Department of Food and Health Sciences, Prefectural University of Kumamoto, Kumamoto, Japan
| | - Kazuko Ishikawa-Takata
- Department of Nutritional epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Tomoki Nakaya
- Department of Geography and Institute of Disaster Mitigation for Urban Cultural Heritage, Ritsumeikan University, Kyoto, Japan
| | - Yasuko Yoshinaka
- Department of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Morioka-cho, Obu, Aichi, Japan
| | - Misaka Kimura
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
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