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Yu Y, Zhang J, Petrovic M, Zhang X, Zhang WH. Utilization of home- and community-based services among older adults worldwide: A systematic review and meta-analysis. Int J Nurs Stud 2024; 155:104774. [PMID: 38703696 DOI: 10.1016/j.ijnurstu.2024.104774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To identify and categorize home- and community-based services used by older adults and the distribution of their utilization, and to examine their utilization patterns in terms of region, time trends, and older adults' characteristics. DESIGN Systematic review and meta-analysis. METHODS We conducted a systematic search of six databases for studies published up to January 12, 2023, and performed meta-analyses and subgroup analyses to identify the utilization of home- and community-based services and analyze utilization patterns concerning region, time trends, and individual characteristics. RESULTS We included 42 studies from 10 countries worldwide, involving a total of 2,942,069 older adults. Home- and community-based services were grouped into three categories: health services, social services, and family caregiver services. Regional differences were consistently evident across all three categories of services, reflecting diverse patterns of home- and community-based service adoption worldwide. Notably, there was a significant increase in the utilization of social services, as distinct from health services and family caregiver services, during the post-2010 period (2010-2018) in comparison with the pre-2010 period (before 2010). In addition, age and cognitive function also played an important role in the utilization of home- and community-based services. CONCLUSION These findings highlight the importance of tailoring home- and community-based services to specific populations and understanding the needs of older adults over time. Further research should be undertaken to gain a deeper understanding of the reasons behind these variations and differences and to provide more targeted and effective services to older adults worldwide.
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Affiliation(s)
- Yushan Yu
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
| | - Jun Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium; The Research Center for Medical Sociology, Tsinghua University, Beijing 100084, China
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
| | - Xudong Zhang
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming 650092, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium; School of Public Health, Université libre de Bruxelles (ULB), Brussels 1070, Belgium.
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Wang X, Liu Z. Navigating Aged Care Services with GIS: Trends, Developments, and Future Directions. BMC Geriatr 2024; 24:243. [PMID: 38468239 PMCID: PMC10926560 DOI: 10.1186/s12877-024-04799-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND With the growing challenge of an aging population, emerging technologies are increasingly being integrated into the production, organization, and delivery of aged care services. Geographic Information System (GIS), a computer-based tool for spatial information analysis and processing, has made significant strides in the allocation of care recources and service delivery for older adults, a notably vulnerable group. Despite its growing importance, cross-disciplinary literature reviews on this theme are scare. This scoping review was conducted to encapsulate the advancements and discern the future trajectory of GIS applications in aged care services. METHODS A comprehensive search across nine databases yielded 5941 articles. Adhering to specific inclusion and exclusion criteria, 61 articles were selected for a detailed analysis. RESULTS The 61 articles span from 2003 to 2022, with a notable increase in publications since 2018, comprising 41 articles (67% of the total) published between 2018-2022. Developed countries contributed 66% of the papers, with 45% focusing on accessibility issues. In the domain of aged care services, GIS has been predominantly utilized for model construction, mapping, and site selection, with a growing emphasis on addressing the unique needs of different subgroups of older adults. CONCLUSION The past two decades have seen substantial growth in the application of GIS in aged care services, reflecting its increasing importance in this field. This scoping review not only charts the historical development of GIS applications in aged care services but also underscores the need for innovative research approaches. Future directions should emphasize the integration of GIS with diverse methodologies to address the heterogeneous needs of older adults and improve the overall delivery of aged care services. Such advancements in GIS applications have the potential to significantly enhance the efficiency, accessibility, and quality of care for the aging population.
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Affiliation(s)
- Xuehan Wang
- School of Public Administration, Central South University, Changsha, Hunan, 410004, China
| | - Zhihan Liu
- School of Public Administration, Central South University, Changsha, Hunan, 410004, China.
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Ueyama M, Tamaki H, Osanai A, Ino Y, Nonomura K, Iwata M, Matsunaga T, Nakamura M, Iguchi K. Relationship between the Number of Pharmacists per Pharmacy and the Provision of Home Healthcare Services in Japan. YAKUGAKU ZASSHI 2024; 144:223-229. [PMID: 38296499 DOI: 10.1248/yakushi.23-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Home healthcare services provided by community pharmacists are essential for maintaining community care, especially in Japan's aging population. Personnel shortage in pharmacies is occasionally cited as the reason why pharmacies are unable to provide home healthcare services. This study examined the relationship between the number of pharmacists in each pharmacy and the provision of home healthcare services. The number of full-time and part-time pharmacists per pharmacy has a positive impact on the provision of home healthcare services. Moreover, the larger the number of pharmacists per pharmacy, the easier it is for the pharmacy to provide home healthcare services. With regard to pharmacies with one full-time pharmacist, there are more pharmacies that provide home healthcare services when the population density of municipalities where the pharmacy is located is high. However, the impact of the number of pharmacists on population density became obscure when the number of full-time pharmacists per pharmacy was three or more. Taken together, these findings indicate that the provision of home healthcare services by pharmacies is related to the number of pharmacists per pharmacy and the population density of the area. This could have implications for widening regional disparities in home healthcare services.
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Affiliation(s)
- Midori Ueyama
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University
| | - Hirofumi Tamaki
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University
| | - Arihiro Osanai
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University
| | - Yoko Ino
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University
| | - Kazuya Nonomura
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University
- Mamiya Dispensing Pharmacy
| | - Mari Iwata
- Kifune Pharmacy
- Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Toshiyuki Matsunaga
- Education Center of Green Pharmaceutical Sciences, Gifu Pharmaceutical University
| | | | - Kazuhiro Iguchi
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University
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Ohashi K, Fujiwara K, Tanikawa T, Bando K, Aoki T, Ogasawara K. Differences in spatial patterns of long-term care depending on severity in Hokkaido, Japan. GEOSPATIAL HEALTH 2022; 17. [PMID: 35579241 DOI: 10.4081/gh.2022.1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
The increasing demand for long-term care (LTC) among the ageing population is a serious problem worldwide, which has greatly increased also in Japan since the introduction of the LTC insurance system there. Since there is a difference between insurers with respect to the proportion of people needing LTC, this study aimed at clarifying the spatial patterns of LTC. Insurer (n=156) LTC data for the period 2012-2019 were obtained from Ministry of Health, Labour, and Welfare and those needing LTC were classified into three classes: total, mild and severe with ageand sex-adjusted proportions needing LTC. Global and local Moran’s I statistics were calculated for each 2-year period to clarify the trends of global and local spatial clusters. From 2012 to 2019, the mean proportion of mild class cases increased (10.6% to 11.6%), whereas that of severe class cases decreased slightly (5.9% to 5.7%). The spatial pattern of the proportion of each class revealed positive spatial autocorrelation. Based on analysis by local Moran’s I, differences in spatial patterns were emphasised between the mild and severe classes. In Hokkaido, High-High clusters of mild cases were identified in the central and southern parts and severe ones in the northern and southern parts. Spatial patterns differed depending on the LTC class. Some insurers had distinctly higher or lower certification rates than those of their neighbourhoods.
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Affiliation(s)
- Kazuki Ohashi
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Hokkaido.
| | - Kensuke Fujiwara
- Graduate School of Commerce, Otaru University of Commerce, Otaru, Hokkaido.
| | - Takumi Tanikawa
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Hokkaido.
| | - Kyohei Bando
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido.
| | - Tomohiro Aoki
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Hokkaido.
| | - Katsuhiko Ogasawara
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Hokkaido.
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Gong Y, Zhou J, Ding F. Investigating the demands for mobile internet-based home nursing services for the elderly. J Investig Med 2021; 70:844-852. [PMID: 34872934 PMCID: PMC8899476 DOI: 10.1136/jim-2021-002118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/16/2022]
Abstract
The great value of home nursing services in the treatment of ailments in elderly patients has attracted increasing attention. This study describes a new mobile internet-based home nursing service system and investigates the reasons for its use among elderly patients. 520 cases of mobile internet-based home nursing services were investigated. The proportion of major reasons to use mobile internet-based home nursing services among the elderly was analyzed and the satisfaction rate was investigated. The constituent ratios of nursing care for pressure ulcers, peripherally inserted central catheter (PICC), subcutaneous injection, general stoma care, psychological care, and intramuscular injection were 61.35%, 28.85%, 6.15%, 1.92%, 1.35%, and 0.38%, respectively. The satisfaction rate with mobile internet-based home nursing services among elderly patients was 100%. Considering the demand for home nursing services for elderly patients, this is the first time that a new mobile internet-based home nursing service has been applied to provide home nursing services to elderly patients and meet their home nursing service needs. Treatment for pressure ulcers, PICC, subcutaneous injection, general stoma care, psychological care, and intramuscular injection were found to be the main reasons to use mobile internet-based home nursing services among the elderly. The new mobile internet-based home nursing service system provides convenient home nursing services to elderly patients and ensures that they get equal rights in home nursing. The results provide basis for healthcare policy makers to formulate new home nursing policies for elderly patients.
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Affiliation(s)
- Yu Gong
- Department of Internal Medicine, Telemedicine Center, Division of Nephrology, Shanghai Municipal Eighth People's Hospital, Shanghai, China
| | - Jianyuan Zhou
- Department of Internal Medicine, Shanghai Municipal Eighth People's Hospital, Shanghai, China
| | - Fang Ding
- Department of Nursing Management, Shanghai Municipal Eighth People's Hospital, Shanghai, China
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Jin X, Tamiya N. The use of Japanese long-term care insurance claims in health services research: current status and perspectives. Glob Health Med 2021; 3:142-148. [PMID: 34250289 DOI: 10.35772/ghm.2021.01000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 11/08/2022]
Abstract
This study aims to evaluate the current status and perspectives on the use of Japanese long-term care (LTC) claims databases for research. We conducted a comprehensive literature search of PubMed and the Japan Medical Abstracts Society (Ichushi-Web), focusing on LTC claims data analyses published between 2000 and 2020. We summarized the study characteristics, database characteristics, and the research areas related to health services that were studied. In total, 86 journal articles (12 in Japanese and 74 in English) were included in our review. A particularly remarkable increase in the number of publications from 2016 to 2020 was observed. We extracted more publications with combined databases (n = 64) than those that only used a single source of the LTC claims databases (n = 22). More than half of the studies analyzed healthcare expenditure, healthcare utilization, and quality of care which were relevant to health services research. The most frequently mentioned limitation was the lack of validation in variables stored in the LTC claims databases. In conclusion, the LTC claims databases could serve as important sources of information for the evaluation of healthcare delivery, quality of care, and LTC policy.
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Affiliation(s)
- Xueying Jin
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Vrabková I, Ertingerová I, Kukuliač P. Determination of gaps in the spatial accessibility of nursing services for persons over the age of 65 with lowered self-sufficiency: Evidence from the Czech Republic. PLoS One 2021; 16:e0244991. [PMID: 33428655 PMCID: PMC7799796 DOI: 10.1371/journal.pone.0244991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/18/2020] [Indexed: 11/19/2022] Open
Abstract
The subject of this research is one of the main preconditions for the provision of high-quality social care services for people over the age of 65 with lowered self-sufficiency. It involves the spatial accessibility of formally established nursing services examined in 76 districts of the Czech Republic. The aim of this article is to identify and evaluate the gaps in spatial accessibility of the selected residential and outpatient-clinic services at the level of districts in individual regions of the Czech Republic in 2018. A three-phase analysis was performed, including an ArcGIS network analysis, multi-criteria evaluation according to the TOPSIS method, and a correlation analysis encompassing the confidence interval gained via the Bootstrap method. Seven indicators were selected-recipients of the allowance for the care, capacity of residential and outpatient-clinic services, and four indicators of accessibility via individual and public transport within the set time intervals. The results show good availability of residential care (no gap) within 30 min. by individual and public transport in most districts (94%). However, day services centers do not have a space gap in only 28% of districts by individual transport, and 8% of districts by public transport. In the case of day care centers, 54% of districts by individual transport, and 29% of districts by public transport do not have a space gap. The results also show that the level of spatial availability of care (gaps) in the district is not related to the number of people aged 65+ with reduced self-sufficiency in the district. On the contrary, the correlation analysis shows that with the growing number of people aged 65+ with reduced self-sufficiency in the district, the capacity of residential and outpatient services increases and the gaps in spatial accessibility do not decrease.
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Affiliation(s)
- Iveta Vrabková
- Faculty of Economics, Department Public Economics, VŠB-TU Ostrava, Czech Republic
| | - Izabela Ertingerová
- Faculty of Economics, Department Public Economics, VŠB-TU Ostrava, Czech Republic
- * E-mail:
| | - Pavel Kukuliač
- Faculty of Mining and Geology, Department of Geoinformatics, VŠB-TU Ostrava, Czech Republic
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Wu Y, Liu Y, Su Z, Sun S, Liu C, Ding W, Gao Y. Demands for Telenursing-Based Long-Term Care Among Disabled Older Adults in Qingdao, China: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:1981-1990. [PMID: 34522091 PMCID: PMC8434935 DOI: 10.2147/ppa.s326413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of the present study was to investigate the current status of and factors influencing the demands for telenursing-based long-term care in disabled older adults. METHODS In this cross-sectional study, data from 213 participants from five districts of Qingdao, China, were investigated using multistage stratified sampling. The assessment scale of the long-term care demands level and the questionnaire of the demands of telenursing-based long-term care for disabled older adults were used to estimate the demands for telenursing-based long-term care for older adults with disabilities in Qingdao. RESULTS Of the participants, 60.51% were willing to receive telenursing-based long-term care. The item with the highest score was "Internet +" information management and first aid (3.77 ± 0.71); the item with the lowest score was "Internet +" daily care (2.97 ± 0.72). Average family income (P < 0.001), age (P = 0.004) and educational level (P = 0.003) were significant factors influencing the demands for telenursing-based long-term care. CONCLUSION Disabled older adults had a high demand for telenursing-based long-term care. Urgent actions are needed to integrate telenursing with long-term care as soon as possible. In the development of telenursing-based long-term care, it is necessary to fully consider the average family income, age and educational level of disabled older adults.
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Affiliation(s)
- Yu Wu
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Yuxiu Liu
- School of Nursing, Weifang Medical University, Weifang, People’s Republic of China
| | - Zhe Su
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Songwei Sun
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
| | - Cuiping Liu
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
| | - Wei Ding
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Yufang Gao
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
- Correspondence: Yufang Gao The Affiliated Hospital of Qingdao University, Qingdao, 266000, People’s Republic of ChinaTel +86-19863737553 Email
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Health Care Needs and Services for Elder and Disabled Population: Findings from a Barcelona Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218071. [PMID: 33147774 PMCID: PMC7663792 DOI: 10.3390/ijerph17218071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 01/25/2023]
Abstract
Health care is a pillar of modern society. This study focuses on the use of descriptive analytics to provide demographic and territorial insights that will be of strategic importance in planning subsequent projects meant to improve health care services. We especially focus on the assessment of the elder and disabled population health care needs in Barcelona, and evaluate to what extent the current health care infrastructure is successful in covering the demand of these fragile population segment. This work is developed around three main assessments in the municipality of Barcelona: the elder and disabled health care demand, the available health care services, and the relationship between demand and services, showing that territorial and demographic aspects are relevant in assessing the health needs of the population.
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Scerpella DL, Adam A, Marx K, Gitlin LN. Implications of Geographic Information Systems (GIS) for targeted recruitment of older adults with dementia and their caregivers in the community: A retrospective analysis. Contemp Clin Trials Commun 2019; 14:100338. [PMID: 30899836 PMCID: PMC6412022 DOI: 10.1016/j.conctc.2019.100338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
5.5 million Americans are living with Alzheimer's dementia (AD) or related dementias. Developing evidence-based interventions for these people and their caregivers (dyads) is a public health priority, and is highly dependent on recruiting representatives from the community. Precision recruitment methodologies are needed to improve the efficiency of this process. Geographic Information Systems (GIS) offer the potential to determine location trends of an older adult population of people living with dementia in the community and their caregivers. American Community Survey (ACS) 2015 5-year estimates were analyzed at the census tract level in ESRI ArcMap v. 10.5.1. Datasets included summarized estimates of age, gender, income, and education in Maryland. Using a two-step process, geographic regions were identified in ArcMap that contained various combinations of available data variables. These areas were compared to participant locations from a previously completed traditional recruitment effort to determine overlap (Dementia Behavior Study - R01AGO41781). The largest number of existing participants were identified in derived regions defined by combining age, education, gender, and income variables; predicting 184 (79%) of 234 participants regardless of the population density within census tracts. 208 (89%) were identified when matching this variable combination to the highest density census tracts (city/urban), and 66 (28%) in regions with the lowest population density (rural). This study successfully defined specific geographic regions in the state of Maryland that overlapped with a large number of known dementia dyad locations obtained via traditional recruitment efforts. Implications for these findings allow for more targeted recruitment efforts of difficult to recruit populations, and less utilization of resources for doing so.
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Affiliation(s)
- Danny L. Scerpella
- Johns Hopkins School of Nursing, Center for Innovative Care in Aging, 901 N. Broadway, Baltimore, MD, 21205, USA
- Corresponding author.
| | - Atif Adam
- Johns Hopkins Bloomberg School of Public Health, Center on Aging and Health, 624 N. Broadway, Room 390, Baltimore, MD, 21205, USA
| | - Katherine Marx
- Johns Hopkins School of Nursing, Center for Innovative Care in Aging, 901 N. Broadway, Baltimore, MD, 21205, USA
| | - Laura N. Gitlin
- Drexel University, 1601 Cherry Street, 10th Floor, Room 1092, Philadelphia, PA, 19102, USA
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Chukwusa E, Verne J, Polato G, Taylor R, J Higginson I, Gao W. Urban and rural differences in geographical accessibility to inpatient palliative and end-of-life (PEoLC) facilities and place of death: a national population-based study in England, UK. Int J Health Geogr 2019; 18:8. [PMID: 31060555 PMCID: PMC6503436 DOI: 10.1186/s12942-019-0172-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/27/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Little is known about the role of geographic access to inpatient palliative and end of life care (PEoLC) facilities in place of death and how geographic access varies by settlement (urban and rural). This study aims to fill this evidence gap. METHODS Individual-level death data in 2014 (N = 430,467, aged 25 +) were extracted from the Office for National Statistics (ONS) death registry and linked to the ONS postcode directory file to derive settlement of the deceased. Drive times from patients' place of residence to nearest inpatient PEoLC facilities were used as a proxy estimate of geographic access. A modified Poisson regression was used to examine the association between geographic access to PEoLC facilities and place of death, adjusting for patients' socio-demographic and clinical characteristics. Two models were developed to evaluate the association between geographic access to inpatient PEoLC facilities and place of death. Model 1 compared access to hospice, for hospice deaths versus home deaths, and Model 2 compared access to hospitals, for hospital deaths versus home deaths. The magnitude of association was measured using adjusted prevalence ratios (APRs). RESULTS We found an inverse association between drive time to hospice and hospice deaths (Model 1), with a dose-response relationship. Patients who lived more than 10 min away from inpatient PEoLC facilities in rural areas (Model 1: APR range 0.49-0.80; Model 2: APR range 0.79-0.98) and urban areas (Model 1: APR range 0.50-0.83; Model 2: APR range 0.98-0.99) were less likely to die there, compared to those who lived closer (i.e. ≤ 10 min drive time). The effects were larger in rural areas compared to urban areas. CONCLUSION Geographic access to inpatient PEoLC facilities is associated with where people die, with a stronger association seen for patients who lived in rural areas. The findings highlight the need for the formulation of end of life care policies/strategies that consider differences in settlements types. Findings should feed into local end of life policies and strategies of both developed and developing countries to improve equity in health care delivery for those approaching the end of life.
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Affiliation(s)
- Emeka Chukwusa
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK.
| | - Julia Verne
- Knowledge and Intelligence (South West), National End of Life Care Intelligence Network, Public Health England, Grosvenor House, 2 Rivergate, Temple Quay, Bristol, BS1 6EH, UK
| | - Giovanna Polato
- Monitoring Analytics (Mental Health, Learning Disability and Substance Misuse), Care Quality Commission (CQC), 151 Buckingham Palace Road, London, SWIW 9SZ, UK
| | - Ros Taylor
- Royal Marsden NHS Hospital Trust, London, SW3 6JJ, UK
- Hospice UK, 34-44 Britannia Street, London, WC1X 9JG, UK
| | - Irene J Higginson
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
| | - Wei Gao
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK
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Kuwayama T, Hamabata K, Kamesaki T, Koike S, Kotani K. Research on Home Care Nursing in Japan Using Geographic Information Systems: A Literature Review. JAPANESE CLINICAL MEDICINE 2018; 9:1179670718814539. [PMID: 30515029 PMCID: PMC6262492 DOI: 10.1177/1179670718814539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 10/29/2018] [Indexed: 11/17/2022]
Abstract
Given Japan’s super-ageing society and its need for developing community-based integrated care system, the role of home care nursing is becoming increasingly important. A central concern in home care nursing is regional/spatial placement of home nursing stations and accessibility for patients. Analysis based on geographic information systems (GIS) may be useful in home care nursing research. We conducted a literature review of home care nursing research based on GIS in Japan. A total of 4 articles were selected following a search of medical literature databases. The first report was published in 2014. Most subjects in the identified studies were older people. Most studies were implemented at a municipal level. Key themes in the identified studies were “placement of specialists and home nursing stations” and “placement of home nursing stations and target patients.” Despite the paucity of research, as all identified studies examined the community areas with an aged population, it may point to the need to consider community-based integrated care systems, including home care nursing, in Japan. More GIS-based research on home care nursing is called for.
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Affiliation(s)
- Takashi Kuwayama
- Center for Community Medicine, Jichi Medical University, Shimotsuke-City, Japan
| | - Kenji Hamabata
- Gerontological Nursing, School of Nursing, Jichi Medical University, Shimotsuke-City, Japan
| | - Toyomi Kamesaki
- Center for Community Medicine, Jichi Medical University, Shimotsuke-City, Japan
| | - Soichi Koike
- Center for Community Medicine, Jichi Medical University, Shimotsuke-City, Japan
| | - Kazuhiko Kotani
- Center for Community Medicine, Jichi Medical University, Shimotsuke-City, Japan
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