Impact on hospital admissions of an integrated primary care model for very frail elderly patients

2014 ◽  
Vol 58 (3) ◽  
pp. 350-355 ◽  
Author(s):  
Matthieu de Stampa ◽  
Isabelle Vedel ◽  
Jean-François Buyck ◽  
Liette Lapointe ◽  
Howard Bergman ◽  
...  
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Frail Elderly ◽  
Hospital Admissions ◽  
Integrated Primary Care ◽  
Care Model ◽  
Primary Care Model

scholarly journals Information and Communication Technologies (ICTs) Enabling Integrated Primary Care for Complex Patients: A Protocol for a Scoping Review

2021 ◽  
Author(s):  
Farah Tahsin ◽  
Alana Armas ◽  
Apery Kirakalaprathapan ◽  
Heather Cunningham ◽  
Mudathira Kadu ◽  
...  
Keyword(s):  
Primary Care ◽  
Information And Communication Technologies ◽  
Scoping Review ◽  
Communication Technologies ◽  
Integrated Primary Care ◽  
Multiple Chronic Conditions ◽  
Care Model ◽  
Primary Care Model ◽  
Complex Patients ◽  
Information And Communication

Abstract IntroductionAn increasing number of individuals are living with multiple chronic conditions, often combined with psychosocial complexities. For these patients with complex conditions, an integrated primary care model that provides care coordination and a team-based approach can help manage their multiple needs. Information and communication technologies (ICTs) are recognized as a critical enabler of integrated primary care. A better understanding of the use of ICTs in an integrated care setting and how ICTs are being leveraged would be beneficial to identify knowledge gaps and could lead to successful implementation for ICT-based interventions.ObjectiveThis study will systematically scope the literature on the topic of ICT-enabled integrated healthcare delivery models for patients with complex care needs to identify which technologies have been used in integrated primary care settings. MethodThis study protocol outlines a scoping review of the peer-reviewed literature, using Arksey and O’Malley’s (enhanced by Levac et al.) scoping review methodology. Peer-reviewed- literature will be identified using a multi-database search strategy. The results of the search will be screened, abstracted, and charted in duplicate by 6 research team members. DiscussionThe key findings of the study will be thematically mapped to describe the implemented ICTs aimed for complex patients within the integrated primary care model and interactions of the elements (ICT, health model, and targeted patients). This review will be the first step to formally identify how ICT is used to support integrated primary health care models. The results will be disseminated through peer-reviewed publications, conference presentations, and special interest groups.

scholarly journals Consulting Psychiatry within an Integrated Primary Care Model

2013 ◽  
Vol 24 (4) ◽  
pp. 1522-1530 ◽  
Author(s):  
Elizabeth A. Zeidler Schreiter ◽  
Nancy Pandhi ◽  
Meghan D. M. Fondow ◽  
Chantelle Thomas ◽  
Jantina Vonk ◽  
...  
Keyword(s):  
Primary Care ◽  
Integrated Primary Care ◽  
Care Model ◽  
Primary Care Model

scholarly journals The impact of medication reviews conducted in primary care on hospital admissions and mortality - a randomized controlled trial

2019 ◽  
Author(s):  
Veronica Milos Nymberg ◽  
Cecilia Lenander ◽  
Beata Borgström Bolmsjö
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Usual Care ◽  
Frail Elderly ◽  
Hospital Admissions ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Medication Reviews ◽  
The Impact

Abstract Background Drug-related problems among the elderly population are common and increasing. Multi-professional medication reviews (MR) have arisen as a method to optimize drug therapy for frail elderly patients. Research has not yet been able to show conclusive evidence of the effect of MRs on mortality or hospital admissions. Aim The aim of this study was to assess the impact of MRs’ on hospital admissions and mortality after six and 12 months in a frail population of 369 patients in primary care in a randomized controlled study. Methods Patients were blindly randomized to an intervention group (receiving MRs) and a control group (receiving usual care). Descriptive data on mortality and hospital admissions at six and 12 months were collected. Survival analysis was performed for time to death and time to the first hospital admission within 12 months. Results Of the total number of 369 included patients, 182 were randomized to the intervention group and 187 to the control group. Most of the patients (75%) were females and lived in nursing homes. At six months, 50 patients of the baseline population (27%) in the control group had been admitted to hospital at least once, compared to 40 patients (21%) in the intervention group. At 12 months, the percentage had increased to 70 (37%) in the control group compared to 53 (29%) in the intervention group. Compared to usual care, we found that MRs reduced the risk of hospital admissions within 12 months by 36% (HR = 0.64, 95% CI 0.45-0.90), but found no difference on mortality (HR = 1.12, 95% CI 0.78-1.61) between the groups. Conclusion We suggest that MRs should be recommended in the care of frail elderly patients with expected benefits on hospital admissions.

scholarly journals 177 Treating Chronic Pain and Preventing Opioid Use Disorders in the Underserved: An Integrated Primary Care Model

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 312-312
Author(s):  
Tanya R. Sorrell ◽  
Rosario Medina
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Behavioral Health ◽  
Integrated Primary Care ◽  
Care Model ◽  
Care Clinic ◽  
Holistic Treatment ◽  
Primary Care Model ◽  
Care Assessment

Abstract:This poster builds on the CDC pain management guidelines and the current ASAM recommendations for substance use assessment to build an integrated primary care model for holistic chronic pain management in an urban, underserved primary care clinic. Using a case from our Federally Qualified Health Care Center, which operates in a southwest Denver clinic, a program of integrated care assessment, diagnosis, and holistic treatment planning is outlined for this client with chronic pain, physical, and behavioral health issues. Using a comprehensive care approach for complex clients, which are typical presentations for urban, underserved clients, we discuss the utilization of best practices in medication management for chronic pain (Alternatives to Opioids (ALTOS), prescribed and complementary and alternative practices (e.g., PT, acupuncture, etc), and behavioral health services (psychiatric assessment and treatment, psychotherapy, support groups, etc) to improve outcomes for our clients.

scholarly journals The impact of medication reviews conducted in primary care on hospital admissions and mortality - an observational follow up of a randomized controlled trial

2020 ◽  
Author(s):  
Veronica Milos Nymberg ◽  
Cecilia Lenander ◽  
Beata Borgström Bolmsjö
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Usual Care ◽  
Frail Elderly ◽  
Hospital Admissions ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Medication Reviews ◽  
The Impact

Abstract Background Drug-related problems among the elderly population are common and increasing. Multi-professional medication reviews (MRs) have arisen as a method to optimize drug therapy for frail elderly patients. Research has not yet been able to show conclusive evidence of the effect of MRs on mortality or hospital admissions. Aim The aim of this study was to assess the impact of MRs’ on hospital admissions and mortality after six and 12 months in a frail population of 369 patients in primary care in a randomized controlled study. Methods Patients were blindly randomized to an intervention group (receiving MRs) and a control group (receiving usual care). Descriptive data on mortality and hospital admissions at six and 12 months were collected. Survival analysis was performed for time to death and time to the first hospital admission within 12 months. Results Of the total number of 369 included patients, 182 were randomized to the intervention group and 187 to the control group. Most of the patients (75%) were females and lived in nursing homes. At six months, 50 patients of the baseline population (27%) in the control group had been admitted to hospital at least once, compared to 40 patients (21%) in the intervention group. At 12 months, the percentage had increased to 70 (37%) in the control group compared to 53 (29%) in the intervention group. Compared to usual care, we found that MRs reduced the risk of hospital admissions within 12 months by 42% (HR = 0.58, 95% CI 0.37-0.92), but found no difference on mortality (HR = 1.12, 95% CI 0.78-1.61) between the groups. Conclusion We suggest that MRs should be recommended in the care of frail elderly patients with expected benefits on delayed hospital admissions.

scholarly journals Effect of an integrated primary care model on the management of middle-aged and old patients with obstructive lung diseases

2007 ◽  
Vol 25 (3) ◽  
pp. 186-192 ◽  
Author(s):  
Marianne A. Meulepas ◽  
Johanna E. Jacobs ◽  
Frank W. J. M. Smeenk ◽  
Ivo Smeele ◽  
Annelies E. M. Lucas ◽  
...  
Keyword(s):  
Primary Care ◽  
Lung Diseases ◽  
Integrated Primary Care ◽  
Care Model ◽  
Middle Aged ◽  
Old Patients ◽  
Obstructive Lung Diseases ◽  
Primary Care Model

scholarly journals PL04: Effectiveness of hospital avoidance interventions among elderly patients: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S6-S6
Author(s):  
A. Ness ◽  
N. Symonds ◽  
M. Siarkowski ◽  
M. Broadfoot ◽  
K. McBrien ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Frail Elderly ◽  
Hospital Admissions ◽  
Home Visits ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Ed Visits

Introduction: Overuse of acute care services, particularly emergency department (ED) use, is an important topic for healthcare providers and policy makers within Canada and abroad. Prior work has shown that frail elderly patients with complex medical needs and limited personal and social resources are heavy users of ED services and are often admitted when they present to the ED. Updated information on the most effective strategies to avert ED presentation and hospital admission focused specifically on elderly patients is needed. Methods: This systematic review addressed the question: what interventions have demonstrated effectiveness in decreasing ED use and hospital admissions in elderly patients? Comprehensive literature searches were conducted in databases including Ovid Medline, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials with no language or date restrictions. Citations were limited to interventional studies. Grey literature and reference list searches, as well as communication with experts in the field were performed. Consensus or a third reviewer resolved any disagreements. Original research regarding interventions conducted in populations 65 years or older with acute illness, either living in community or facility-living were included. Primary outcomes were ED visits and hospital admissions. Secondary outcomes included: mortality, cost, and patient-reported outcomes such as health-related quality of life and functional status. Results: Forty-three relevant studies were identified including 22 randomized controlled trials (RCT), 2 cluster-RCT, 2 trials with non-random allocation, 4 before-after studies, 6 quasi-experimental studies, and 7 cohort studies. Intervention settings included: home visits (22), long-term care (7), outpatient or primary care clinics (8), and ED (3) or inpatient (3). Data characterization revealed that home-based, outpatient and/or primary care-based strategies reduced ED visits and hospitalizations, particularly those which included comprehensive geriatric assessments, home visits or regular face-to-face contact and interdisciplinary teams. Hospital-based models generally showed no difference in ED or inpatient service utilization. There was, however, considerable variability across individual studies with respect to reporting of outcomes, statistical analyses performed, and overall risk of bias. Conclusion: Various interventional strategies have been studied to avert ED presentation and hospital admission for frail elderly patients. More rigorous methodology and standardization of outcome measures is needed to quantitatively assess the effects of these programs.

Sign in / Sign up

Export Citation Format

Share Document