BackgroundThis study explored the effects of an integrated care model aimed at the frail elderly on the perceived health, objective burden, subjective burden and quality of life of informal caregivers.MethodsA quasi-experimental design with before/after measurement (with questionnaires) and a control group was used. The analysis encompassed within and between groups analyses and regression analyses with baseline measurements, control variables (gender, age, co-residence with care receiver, income, education, having a life partner, employment and the duration of caregiving) and the intervention as independent variables.ResultsThe intervention significantly contributed to the reduction of subjective burden and significantly contributed to the increased likelihood that informal caregivers assumed household tasks. No effects were observed on perceived, health, time investment and quality of life.ConclusionsThis study implies that integrated care models aimed at the frail elderly can benefit informal caregivers and that such interventions can be implemented without demanding additional time investments from informal caregivers. Recommendations for future interventions and research are provided.Trial registrationCurrent Controlled Trials http://ISRCTN05748494. Registration date: 14/03/2013.
ObjectiveThis study explores the processes of integration that are assumed to underlie integrated care delivery.DesignA quasi-experimental design with a control group was used; a new instrument was developed to measure integration from the professional perspective.Setting and participantsProfessionals from primary care practices and home-care organizations delivering care to the frail elderly in the Walcheren region of the Netherlands.InterventionAn integrated care intervention specifically targeting frail elderly patients was implemented.Main Outcome MeasuresStructural, cultural, social and strategic integration and satisfaction with integration.ResultsThe intervention significantly improved structural, cultural and social integration, agreement on goals, interests, power and resources and satisfaction with integration.ConclusionsThis study confirms that integrated care structures foster processes of integration among professionals.Trial registrationCurrent Controlled Trials ISRCTN05748494.
Background:The impact of integrated working on professionals’ objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary care practice as a single entry point, and included proactive frailty screening, a comprehensive assessment of patient needs, case management, multidisciplinary teams, care plans and protocols, task delegation and task specialisation, a shared information system, a geriatric care network and integrated funding.Methods:A quasi-experimental design with a control group was used. Data regarding objective burden involved the professionals’ time investments over a 12-month period that were collected from patient medical records (n = 377) time registrations, transcripts of meetings and patient questionnaires. Data regarding job satisfaction were collected using questionnaires that were distributed to primary care and home-care professionals (n = 180) after the intervention’s implementation. Within- and between-groups comparisons and regression analyses were performed.Results:Non-patient related time was significantly higher in the experimental group than in the control group, whereas patient-related time did not differ. Job satisfaction remained unaffected by the intervention.Conclusion and Discussion:Integrated working is likely to increase objective burden as it requires professionals to perform additional activities that are largely unrelated to actual patient care. Implications for research and practice are discussed. [Current Controlled Trials ISRCTN05748494].
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