Hospital-at-home integrated care programme for older patients with orthopaedic conditions: Early community reintegration maximising physical function

Mas, Miquel Àngel; Closa, Conxita; Santaeugènia, Sebastià; Inzitari, Marco; Ribera, Aída; Gallofré, Miquel

doi:10.1016/j.maturitas.2016.03.005

Cited by 23 publications

(9 citation statements)

References 28 publications

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“…The most common types of task shifting were from health workers to either the patient’s caregivers [ 40 , 45 , 46 ] or peers and volunteers [ 47 – 50 ] as well as from specialised rehabilitation workers to primary care workers [ 43 , 51 ]. Twenty-four studies (25%) reported multidisciplinary teams (three different health workers or more) working at PC, mostly including nurses, geriatricians, and general practitioners (or “family doctors”) [ 52 – 54 ]; or PTs, OTs and other types of physicians [ 46 , 55 – 57 ]. The main characteristics of the rehabilitation programmes and dosage information of each included study are available as Additional files 5 and 6 , Tables S3 and S4.…”

Section: Resultsmentioning

confidence: 99%

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models

Seijas,

Maritz,

Mishra

et al. 2024

BMC Health Serv Res

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Background The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided. Methods We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015–2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)’s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis. Results We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. Conclusions We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.

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Section: Resultsmentioning

confidence: 99%

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models

Seijas,

Maritz,

Mishra

et al. 2024

BMC Health Serv Res

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“…Most common types of task shifting were from health workers to either the patient's caregivers (34,39,40) or peers and volunteers (41,42,43,44) as well as from specialized rehabilitation workers to primary care workers (37,45). Twenty-four studies (25%) reported multidisciplinary teams (three different health workers or more) working at PHC, mostly including nurses, geriatricians, and general physicians(46, 47, 48); or PTs, OTs and other type of physician (40,49,50,51). The main characteristics of the rehabilitation programmes and dosage information per included study are available as Additional Files 6 and 7, Tables S2 and S3.…”

Section: Rehabilitation Programs' Bene Ciaries (Table 1)mentioning

confidence: 99%

Rehabilitation in Primary Health Care for the ageing population: A secondary analysis from a scoping review of rehabilitation models for the ageing population

Seijas

Maritz²,

Mishra

et al. 2023

Preprint

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Background: The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary health care (PHC) is needed to optimise access to rehabilitation for the ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PHC to the ageing population, and b) to explore age-related differences in the type of rehabilitation services provided. Methods: We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PHC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50+. Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the PHC systems (PRIMASYS) approach and the WHO paper on rehabilitation in PHC. Data synthesis included quantitative and qualitative analysis. Results: We synthesised data from 96 studies with 31,956 participants and identified five models for rehabilitation in PHC for the ageing population: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. Conclusions: By understanding models of rehabilitation service delivery in PHC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of the ageing population, considering multimorbidity, evidence of heterogeneity in the ageing process, and the importance of using limitations in functioning as a starting point. Our findings, highlight rehabilitation's role in healthy ageing and are a valuable resource for informing policy, practice, and future research in the context of the United Nations Decade of Healthy Ageing. They can also inform WHO's ongoing efforts to strengthen PHC for the provision of rehabilitation, as recommended by the Rehab2030 initiative and reaffirmed by the recently adopted World Health Assembly (WHA) resolution on strengthening rehabilitation in health systems.

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“…Within the context of Catalonia, since 1985, the HaH model has been officially recognized as a healthcare activity or service. In spite of this legal framework, the posterior evolution of the healthcare system within the territory has not led to the program’s homogenous development [ 8 , 10 , 11 , 12 , 13 , 14 ]. This has resulted in the appearance of HaH units without any pre-established or defined resource structures and with varying service portfolios, all of which have hindered a common evaluation.…”

Section: Introductionmentioning

confidence: 99%

Differences in Results and Related Factors between Hospital-At-Home Modalities in Catalonia: A Cross-Sectional Study

Torre

Zioga

Macorigh

et al. 2020

JCM

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Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered—admission avoidance (n = 7214; 75.1%) and early assisted discharge (n = 2387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities.

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Hospital-at-home integrated care programme for older patients with orthopaedic conditions: Early community reintegration maximising physical function

Cited by 23 publications

References 28 publications

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models

Rehabilitation in Primary Health Care for the ageing population: A secondary analysis from a scoping review of rehabilitation models for the ageing population

Differences in Results and Related Factors between Hospital-At-Home Modalities in Catalonia: A Cross-Sectional Study

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