1
|
Caponnetto V, Dante A, El Aoufy K, Melis MR, Ottonello G, Napolitano F, Ferraiuolo F, Camero F, Cuoco A, Erba I, Rasero L, Sasso L, Bagnasco A, Alvaro R, Manara DF, Rocco G, Zega M, Cicolini G, Mazzoleni B, Lancia L. Community health services in European literature: A systematic review of their features, outcomes, and nursing contribution to care. Int Nurs Rev 2024. [PMID: 39073363 DOI: 10.1111/inr.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored. INTRODUCTION Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing-related determinants of outcomes. METHODS A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856). RESULTS Twenty-three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services' effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long-term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated. DISCUSSION Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models. CONCLUSIONS AND IMPLICATIONS FOR HEALTH POLICY Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.
Collapse
Affiliation(s)
- Valeria Caponnetto
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Angelo Dante
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Giulia Ottonello
- Department of Health Sciences, University of Genoa, Genova, Italy
- Ingram School of Nursing, McGill University, Montreal, Canada
- Direction of Health Professionals, "IRCCS Istituto Giannina Gaslini,", Genova, Italy
| | - Francesca Napolitano
- Department of Health Sciences, University of Genoa, Genova, Italy
- Department of Emergency and Admission, Policlinic Hospital "IRCSS San Martino,", Genova, Italy
| | - Fabio Ferraiuolo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesco Camero
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Angela Cuoco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Orthopedic and Traumatology Clinic, Orthopedic Institute "IRCSS Rizzoli,", Bologna, Italy
| | - Ilaria Erba
- Bachelor of Science in Nursing, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Laura Rasero
- Department of Health Sciences, University of Florence, Florence, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genova, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Genova, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Duilio Fiorenzo Manara
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| | - Gennaro Rocco
- Center of Excellence for Nursing Scholarship, Rome, Italy
- Faculty of Medicine, University "Our Lady of the Good Counsel", Tirana, Albania
| | - Maurizio Zega
- Center of Excellence for Nursing Scholarship, Rome, Italy
- FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Giancarlo Cicolini
- FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
- Section of Nursing and Midwifery, Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti - Pescara, Chieti, Italy
| | - Beatrice Mazzoleni
- FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Loreto Lancia
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| |
Collapse
|
3
|
Brettel JH, Manuwald U, Hornstein H, Kugler J, Rothe U. Chronic-Care-Management Programs for Multimorbid Patients with Diabetes in Europe: A Scoping Review with the Aim to Identify the Best Practice. J Diabetes Res 2021; 2021:6657718. [PMID: 34796236 PMCID: PMC8595013 DOI: 10.1155/2021/6657718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 10/20/2021] [Indexed: 11/29/2022] Open
Abstract
AIM This scoping review is aimed at providing a current descriptive overview of care programs based on the chronic care model (CCM) according to E. H. Wagner. The evaluation is carried out within Europe and assesses the methodology and comparability of the studies. METHODS A systematic search in the databases PubMed, Embase, and MEDLINE via OVID was conducted. In the beginning, 2309 articles were found and 48 full texts were examined, 19 of which were incorporated. Included were CCM-based programs from Belgium, Cyprus, Germany, Italy, Switzerland, and the Netherlands. All 19 articles were presented descriptively whereof 11 articles were finally evaluated in a checklist by Rothe et al. (2020). In this paper, the studies were tabulated and evaluated conforming to the same criteria. RESULTS Due to the complexity of the CCM and the heterogeneity of the studies in terms of setting and implementation, a direct comparison proved difficult. Nevertheless, the review shows that CCM was successfully implemented in various care situations and also can be useful in single practices, which often dominate the primary care sector in many European health systems. The present review was able to provide a comprehensive overview of the current care situation of chronically ill patients with multimorbidities. CONCLUSIONS A unified nomenclature concerning the distinction between disease management programs and CCM-based programs should be aimed for. Similarly, homogeneous quality standards and a Europe-wide evaluation strategy would be necessary to identify best practice models and to provide better care for the steadily growing number of chronically multimorbid patients.
Collapse
Affiliation(s)
- Julia Heike Brettel
- Technische Universität Dresden, Faculty of Medicine “Carl Gustav Carus”, IPAS/Health Sciences/Public Health, Fetscherstraße 74, 01307 Dresden, Germany
| | - Ulf Manuwald
- Technische Universität Dresden, Faculty of Medicine “Carl Gustav Carus”, IPAS/Health Sciences/Public Health, Fetscherstraße 74, 01307 Dresden, Germany
| | - Henriette Hornstein
- Technische Universität Dresden, Faculty of Medicine “Carl Gustav Carus”, IPAS/Health Sciences/Public Health, Fetscherstraße 74, 01307 Dresden, Germany
| | - Joachim Kugler
- Technische Universität Dresden, Faculty of Medicine “Carl Gustav Carus”, IPAS/Health Sciences/Public Health, Fetscherstraße 74, 01307 Dresden, Germany
| | - Ulrike Rothe
- Technische Universität Dresden, Faculty of Medicine “Carl Gustav Carus”, IPAS/Health Sciences/Public Health, Fetscherstraße 74, 01307 Dresden, Germany
| |
Collapse
|
4
|
Chen TT, Oldenburg B, Hsueh YS. Chronic care model in the diabetes pay-for-performance program in Taiwan: Benefits, challenges and future directions. World J Diabetes 2021; 12:578-589. [PMID: 33995846 PMCID: PMC8107979 DOI: 10.4239/wjd.v12.i5.578] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
In this review, we discuss the chronic care model (CCM) in relation to the diabetes pay-for-performance (P4P) program in Taiwan. We first introduce the 6 components of the CCM and provide a detailed description of each of the activities in the P4P program implemented in Taiwan, mapping them onto the 6 components of the CCM. For each CCM component, the following three topics are described: the definition of the CCM component, the general activities implemented related to this component, and practical and empirical practices based on hospital or local government cases. We then conclude by describing the possible successful features of this P4P program and its challenges and future directions. We conclude that the successful characteristics of this P4P program in Taiwan include its focus on extrinsic and intrinsic incentives (i.e., shared care network), physician-led P4P and the implementation of activities based on the CCM components. However, due to the low rate of P4P program coverage, approximately 50% of patients with diabetes cannot enjoy the benefits of CCM-related activities or receive necessary examinations. In addition, most of these CCM-related activities are not allotted an adequate amount of incentives, and these activities are mainly implemented in hospitals, which compared with primary care providers, are unable to execute these activities flexibly. All of these issues, as well as insufficient implementation of the e-CCM model, could hinder the advanced improvement of diabetes care in Taiwan.
Collapse
Affiliation(s)
- Tsung-Tai Chen
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei 24205, Taiwan
| | - Brian Oldenburg
- Noncommunicable Disease Control Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3053, Australia
| | - Ya-Seng Hsueh
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3053, Australia
| |
Collapse
|
5
|
Mustonen K, Kauppila T, Rahkonen O, Kantonen J, Raina M, Mäki T, Pitkälä K. Variations in older people's use of general practitioner consultations and the relationship with mortality rate in Vantaa, Finland in 2003-2014. Scand J Prim Health Care 2019; 37:452-458. [PMID: 31709880 PMCID: PMC6883416 DOI: 10.1080/02813432.2019.1684426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: It is generally expected that the growth of the older population will lead to an increase in the use of health care services. The aim was to examine the changes in the number of visits made to general practitioners (GP) by the older age groups, and whether such changes were associated with changes in mortality rates.Design and setting: A register-based observational study in a Finnish city where a significant increase in the older population took place from 2003 to 2014. The number of GP visits made by the older population was calculated, the visits per person per year in two-year series, together with respective mortality rates.Subjects: The study population consisted of inhabitants aged 65 years and older (65+) in Vantaa that visited a GP in primary health care.Main outcome measures: The number of GP visits per person per year in the whole older population during the study years.Results: In 2009-2010, there was a sudden drop in GP visits per person in the younger (65-74 years) age groups examined. In the population aged 85+, use of GP visits remained at a fairly constant level. The mortality rate decreased until the year 2008. After that, the positive trend ended and the mortality rate plateaued.Conclusions: Simultaneously with the decline in GP visits per person in the older population, the mortality rate leveled off from its positive trend in 2009-2010. Factors identified being associated with the number of GP consultations were organizational changes in primary health care, economic recession causing retrenchment, and even vaccinations during the swine flu epidemic.Key pointsAlong with an increasingly ageing population, concern over the supply of publicly funded health care has become more pronounced.The amount of GP visits of 65+ decreased in primary health care, especially in the youngest groups.However, in the oldest age groups (85+), the use of GPs remained unchanged regardless of changes in service supply.As the rate of GP visits among the population of 65+ declined, the positive trend in the mortality rate ceased.
Collapse
Affiliation(s)
- Katri Mustonen
- Department of General Practice and Primary Health Care, Faculty of Medicine, University of Helsinki, Finland;
- CONTACT Katri Mustonen Department of General Practice and Primary Health Care, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, Helsinki 00014, Finland
| | - Timo Kauppila
- Department of General Practice and Primary Health Care, Faculty of Medicine, University of Helsinki, Finland;
| | - Ossi Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland;
| | - Jarmo Kantonen
- Health Care and Social Services, City of Vantaa, Finland;
- Attendo LDT, Helsinki, Finland;
| | - Marko Raina
- Health Care and Social Services, City of Vantaa, Finland;
- Oy Apotti Ab, Helsinki, Finland;
| | - Tiina Mäki
- HUSLAB Laboratory Services, Helsinki University Hospital, Helsinki, Finland;
| | - Kaisu Pitkälä
- Department of General Practice and Primary Health Care, Faculty of Medicine, University of Helsinki, Finland;
- Helsinki University Hospital, Unit of Primary Health Care, Helsinki, Finland
| |
Collapse
|