Community care in Europe. The Aged in HOme Care project (AdHOC)

2004 ◽  
Vol 16 (4) ◽  
pp. 259-269 ◽  
Author(s):  
Iain Carpenter ◽  
Giovanni Gambassi ◽  
Eva Topinkova ◽  
Marianne Schroll ◽  
Harriett Finne-Soveri ◽  
...  
Keyword(s):  
Home Care ◽  
Community Care ◽  
Care Project

scholarly journals Paramedics assessing patients with complex comorbidities in community settings: results from the CARPE study

CJEM ◽  
2021 ◽  
Author(s):  
Matthew S. Leyenaar ◽  
Brent McLeod ◽  
Aaron Jones ◽  
Audrey-Anne Brousseau ◽  
Eric Mercier ◽  
...  
Keyword(s):  
Home Care ◽  
Support Services ◽  
Home Visit ◽  
Community Care ◽  
Community Support ◽  
Community Dwelling ◽  
Living Alone ◽  
Care Providers ◽  
Community Paramedicine ◽  
Community Support Services

Abstract Objectives The aim for this study was to provide information about how community paramedicine home visit programs best “navigate” their role delivering preventative care to frequent 9-1-1 users by describing demographic and clinical characteristics of their patients and comparing them to existing community care populations. Methods Our study used secondary data from standardized assessment instruments used in the delivery of home care, community support services, and community paramedicine home visit programs in Ontario. Identical assessment items from each instrument enabled comparisons of demographic, clinical, and social characteristics of community-dwelling older adults using descriptive statistics and z-tests. Results Data were analyzed for 29,938 home care clients, 13,782 community support services clients, and 136 community paramedicine patients. Differences were observed in proportions of individuals living alone between community paramedicine patients versus home care clients and community support clients (47.8%, 33.8%, and 59.9% respectively). We found higher proportions of community paramedicine patients with multiple chronic disease (87%, compared to 63% and 42%) and mental health-related conditions (43.4%, compared to 26.2% and 18.8% for depression, as an example). Conclusion When using existing community care populations as a reference group, it appears that patients seen in community paramedicine home visit programs are a distinct sub-group of the community-dwelling older adult population with more complex comorbidities, possibly exacerbated by mental illness and social isolation from living alone. Community paramedicine programs may serve as a sentinel support opportunity for patients whose health conditions are not being addressed through timely access to other existing care providers. Protocol registration ISRCTN 58273216.

scholarly journals P035: Impact of EMS direct referral to community care on emergency department utilization

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S75
Author(s):  
A. Dukelow ◽  
M. Lewell ◽  
J. Loosley ◽  
S. Pancino ◽  
K. Van Aarsen
Keyword(s):  
Emergency Department ◽  
Home Care ◽  
Community Care ◽  
Home Care Services ◽  
Emergency Department Visits ◽  
Emergency Department Utilization ◽  
Care Services ◽  
Significant Difference ◽  
Ed Visits ◽  
The Impact

Introduction: The Community Referral by Emergency Medical Services (CREMS) program was implemented in January 2015 in Southwestern Ontario. The program allows Paramedics interacting with a patient to directly refer those in need of home care support to their local Community Care Access Centre (CCAC) for needs assessment. If indicated, subsequent referrals are made to specific services (e.g. nursing, physiotherapy and geriatrics) by CCAC. Ideally, CREMS connects patients with appropriate, timely care, supporting individual needs. Previous literature has indicated CREMS results in an increase of home care services provided to patients. Methods: The primary objective of this project is to evaluate the impact of the CREMS program on Emergency Department utilization. Data for all CCAC referrals from London-Middlesex EMS was collected for a thirteen month period (February 2015-February 2016). For all patients receiving a new or increased service from CCAC the number of Emergency Department visits 2 years before referral and 2 years after referral were calculated. A related samples Wilcoxon Signed Rank Test was performed to examine the difference in ED visits pre and post referral to CCAC. Results: There were 213 individuals who received a new or increased service during the study timeframe. Median [IQR] patient age was 77 [70-85.5]. 113/213 (53%) of patients were female. The majority of patients 135/213 (63.4%) were a new referral to CCAC. The median [IQR] number of hospital visits before referral was 3 [1-5] and after referral was 2 [0-4]. There was no significant difference in the overall number of ED visits before versus after referral (955 vs 756 visits, p = 0.051). Conclusion: Community based care can improve patient experience and health outcomes. Paramedics are in a unique position to assess patients in their home to determine who might benefit from home care services. CREMS referrals for this patient group showed a trend towards decreased ED visits after referral but the trend was not statistically significant.

Suicide and Community Care

1967 ◽  
Vol 113 (505) ◽  
pp. 1381-1391 ◽  
Author(s):  
David Walk
Keyword(s):  
Social Work ◽  
Home Care ◽  
Community Service ◽  
Community Care ◽  
Psychiatric Patients

In recent years there has been a considerable shift towards the treatment of psychiatric patients outside hospital; and although progress in the expansion of such services as hostels, day centres and social work has in many places been slow, the idea of a Community Service based on home care whenever possible has become a popular one and forms the basis of official planning in this country (16). Doubts have, however, been expressed as to the wisdom of so great an emphasis on this untried method of management (13, 34, 39); the proper evaluation of Community Care is therefore of great importance.

Gatekeepers to home and community care services: the link between client characteristics and source of referral

2013 ◽  
Vol 37 (3) ◽  
pp. 356 ◽  
Author(s):  
Nerina Vecchio
Keyword(s):  
Home Care ◽  
Community Care ◽  
Health Workers ◽  
Multinomial Logistic Regression ◽  
Care Program ◽  
Ageing Population ◽  
Community Factors ◽  
Care Services ◽  
Healthcare Needs ◽  
Home And Community Care

Objectives. To identify characteristics associated with the likelihood of a client receiving a referral to the Home and Community Care (HACC) program from various sources. Methods. Data were collected from 73 809 home care clients during 2007–08. Binary logistic and multinomial logistic regression were used to investigate the likelihood of a client being referred by health workers v. non-health workers. Results. Females and clients cared for by their parents were less likely to receive referrals from health workers than non-health workers after confounding variables were controlled for. While poorer functional ability of clients increased the probability of receiving a referral from a health worker, the opposite was true for those with behavioural problems. Over 43% of the sample either self-referred or was referred by family or friends. Conclusions. Eligible individuals may miss out on services unless they or their family take the initiative to refer. There is a need for improved methods and incentives to support and encourage health workers to refer eligible individuals to the program. What is known about the topic? The absence or inappropriate referral to a suitable home care program can place pressure on formalised institutions and increase burdens on family members and the community. Factors largely unrelated to healthcare needs carry significant weight in determining hospital discharge decisions and home care referrals by practitioners. What does this paper add? The effectiveness of the HACC program is dependent on the referrer who acts to inform and facilitate individuals to the program. The purpose of this study is to identify the characteristics associated with the likelihood of individuals receiving a referral to the HACC program from various sources. What are the implications for practitioners? This study will assist policy makers and practitioners in developing effective strategies that transition individuals to suitable home care services in a timely manner. An effective referral process would provide opportunities for implementing preventative strategies that reduce disability rates among individuals and the burden of care for the community. For instance, individuals with unmet needs may be at higher risk from injury at home through inadequate monitoring of nutrient and medication intake and inappropriate home surroundings. Improving knowledge about care options and providing appropriate incentives that encourage health workers to refer individuals would be an effective start in improving the health outcomes of an ageing population.

Indicators of Consistency of Home Care Providers under Managed Competition: A Case Report from Ontario

2003 ◽  
Vol 16 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Melanie Harju ◽  
Christel A. Woodward
Keyword(s):  
Case Report ◽  
Home Care ◽  
Community Care ◽  
Managed Competition ◽  
Care Providers ◽  
Care Access ◽  
Home Care Providers ◽  
The Impact

The study reported in this article examined the components of the benchmarks used to monitor consistency of provider by home care agencies competing for nursing and homemaking contracts in the Hamilton-Wentworth Community Care Access Centre. Comparisons of the impact on provider continuity of varying components of the benchmarks demonstrated that current benchmarks reveal little about the extent to which consistency of provider is achieved. Uniform standards must be adopted to allow for comparisons across agencies.

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