scholarly journals The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program

2016 ◽  
Vol 45 (2) ◽  
pp. 317-320 ◽  
Author(s):  
Tracy A. Comans ◽  
Nancye M. Peel ◽  
Ruth E. Hubbard ◽  
Andrew D. Mulligan ◽  
Leonard C. Gray ◽  
...  
Keyword(s):  
Older People ◽  
Healthcare Costs ◽  
Care Program ◽  
Transition Care

scholarly journals Healthcare resource use in patients of the Australian Transition Care Program

2015 ◽  
Vol 39 (4) ◽  
pp. 411 ◽  
Author(s):  
Tracy A. Comans ◽  
Nancye M. Peel ◽  
Ian D. Cameron ◽  
Leonard Gray ◽  
Paul A. Scuffham
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Hospital Costs ◽  
Care Program ◽  
Healthcare Resource Use ◽  
Admission Rates ◽  
Care Recipients ◽  
Transition Care ◽  
The Cost

Objective The aim of the present study was to describe, from the perspective of the healthcare funder, the cost components of the Australian Transition Care Program (TCP) and the healthcare resource use and costs for a group of transition care clients over a 6-month period following admission to the program. Methods A prospective cohort observational study of 351 consenting patients entering community-based transition care at six sites in two states in Australia from November 2009 to September 2010 was performed. Patients were followed up 6 months after admission to the TCP to ascertain current living status and hospital re-admissions over the follow-up period. Cost data were collected by transition care teams and from administrative data (hospital and Medicare records). Results The TCP provides a range of services with most costs attributed to provision of personal care support, case management, physiotherapy and occupational therapy. Most healthcare costs up to 6 months after transition care admission were incurred from the hospital admission leading to transition care and from re-admissions. Orthopaedic conditions incurred the highest costs, with many of these for elective procedures and others resulting from falls. Hospital re-admission rates in the present study were 10% lower than in a previous evaluation of the TCP. Over 6 months, approximately 40% of patients in the study were re-admitted to hospital at an average cost of A$7038. Conclusions Although the cost of the TCP is relatively high, it may have some impact on reducing hospital re-admissions and preventing or delaying residential care admissions. What is known about the topic? A majority of healthcare costs occur in older age. What does this paper add? Hospital costs, both initial and re-admissions, are the major contributor to healthcare costs in transition care recipients. Orthopaedic conditions are the most expensive to treat and neurological conditions are the most variable. What are the implications for practitioners? Reducing the length of hospitalisation and reducing re-admissions for older frail people is a key economic concern for health services. Services such as the TCP aim to do both; however, the evidence that this is effective is limited. Streamlining referrals to transition care to enable earlier access and involving the transition care provider in re-admission decisions may help reduce healthcare costs in future.

IMPACT OF POST-ACUTE TRANSITION CARE FOR FRAIL OLDER PEOPLE: A PROSPECTIVE STUDY

2013 ◽  
pp. 1-7
Author(s):  
N.M. PEEL ◽  
R.E. HUBBARD ◽  
L.C. GRAY
Keyword(s):  
Older People ◽  
Care Program ◽  
Aged Care ◽  
Functional Improvement ◽  
Residential Aged Care ◽  
Frail Older People ◽  
Care Needs ◽  
Post Discharge ◽  
Transition Care

Objectives:To describe the characteristics and outcomes of frail older people in a post-acutetransitional care program and to compare the recovery trajectories of patients with high and low care needs todetermine who benefits from transition care. Design:Prospective observational cohort. Participants and Setting:351 patients admitted to community-based transition care in two Australian states during an 11 monthrecruitment period. Intervention:Transition care provides a package of services including personal care,physiotherapy and occupational therapy, nursing care and case management post discharge from hospital. It istargeted at frail older people who, in the absence of an alternative, would otherwise be eligible for admission toresidential aged care. Measurements: A comprehensive geriatric assessment using the interRAI Home Careinstrument was conducted at transition care admission and discharge. Primary outcomes included changes infunctional ability during transition care, living status at discharge and six months follow-up, and hospital re-admissions over the follow-up period. For comparison of outcomes, the cohort was divided into two groups basedon risk factors for admission to high or low-level residential aged care. Results:There were no significantdifferences between groups on outcomes, with over 85% of the cohort living in the community at follow-up.More than 80% of the cohort showed functional improvement or maintenance of independence during transitioncare, with no significant differences between the groups. Conclusions:Post-acute programs should not betargeted solely at fitter older people: those who are frail also have the potential to gain from community-basedrehabilitation.

scholarly journals The distribution of health services for older people in Australia: where does transition care fit?

2009 ◽  
Vol 33 (4) ◽  
pp. 572 ◽  
Author(s):  
Lynne C Giles ◽  
Julie A Halbert ◽  
Maria Crotty ◽  
Ian D Cameron ◽  
Len C Gray
Keyword(s):  
Rural Communities ◽  
Older People ◽  
Rural Areas ◽  
Care Service ◽  
Care Program ◽  
Aged Care ◽  
Care Services ◽  
Transition Care ◽  
Care Assessment ◽  
Hospital Beds

Introduction: The purpose of this study was to describe the distribution of hospital and aged care services for older people, with a particular focus on transition care places, across Australia and to determine the relationships between the provision of these services. Methods: Aggregation of health and aged care service indicators by Aged Care Assessment Team (ACAT) region including: public and private acute and subacute (rehabilitation and geriatric evaluation and management) hospital beds, flexible and mainstream aged care places as at 30 June 2006. Results: There was marked variation in the distribution of acute and subacute hospital beds among the 79 ACAT regions. Aged care places were more evenly distributed. However, the distribution of transition care places was uneven. Rural areas had poorer provision of all beds. There was no evidence of coordination in the allocation of hospital and aged care services between the Commonwealth and state/territory governments. There was a weak relationship between the allocation of transition care places and the distribution of health and aged care services. Discussion: Overall, the distribution of services available to older persons is uneven across Australia. While the Transition Care Program is flexible and is providing rural communities with access to rehabilitation, it will not be adequate to address the increasing needs associated with the ageing of the Australian population. An integrated national plan for aged care and rehabilitation services should be considered.

scholarly journals Treatment Fidelity of an Evidence-Based Nurse-Led Intervention in a Proactive Primary Care Program for Older People

2016 ◽  
Vol 13 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Nienke Bleijenberg ◽  
Valerie H. ten Dam ◽  
Irene Drubbel ◽  
Mattijs E. Numans ◽  
Niek J. de Wit ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Care Program ◽  
Treatment Fidelity ◽  
Evidence Based ◽  
Primary Care Program

scholarly journals Effects of Nurse and Care Worker-led Foot-Care Program on Older People’s Foot Conditions: Before and After Intervention Study

2021 ◽  
Vol 7 ◽  
pp. 237796082110584
Author(s):  
Kashiko Fujii ◽  
Minna Stolt ◽  
Takuyuki Komoda ◽  
Mariko Nishikawa
Keyword(s):  
Older People ◽  
Day Care ◽  
Intervention Study ◽  
Care Program ◽  
Skin Lesions ◽  
Foot Care ◽  
Term Care ◽  
Foot Health ◽  
Day Care Centers ◽  
Before And After

Introduction An increasing number of older people with frailty in Japan use geriatric day care centers. Older people who have been certified as requiring long-term care attend centers during the day and receive nursing care help with bathing, excretion, meals, and functional training services. Many older people have foot problems with need foot care by nurses and care workers (NCWs) at geriatric day care centers. Objective This study explored the effects of NCWs’ foot-care programs on the foot conditions of older people attending daytime services. Methods A before-after intervention study was conducted at geriatric day care centers for older people, where the foot-care program was presented by NCWs for two months. The foot conditions of 23 clients (8 men, 15 women, mean age = 78.6 years, standard deviation = 9.2) were assessed before and after the program. Changes in foot condition and clients’ perceptions after the study were analyzed through descriptive statistics, McNemar, and paired t-tests. Results Although dramatic changes in foot conditions were not observed, some conditions were improved or maintained. Changes were observed in mean dry skin scores ( p < .01; right foot: 1.6→1.1, left foot: 1.6→1.1), skin lesions and long nails (skin lesions R: 0.2→0.1; long nail R: 1.4→1.0, L: 1.1→0.8), and edema (R: 43.5%→39.1%, L: 52.2%→47.8%). Further, clients started perceiving that foot health is important and discussed their feet with staff more often. Conclusion The NCWs’ foot-care program was effective in maintaining and improving foot health in older people and positively affected their perception of foot care.

Outcomes of cognitively impaired older people in Transition Care

2014 ◽  
Vol 34 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Nancye May Peel ◽  
Kah Wai Chan ◽  
Ruth Eleanor Hubbard
Keyword(s):  
Older People ◽  
Cognitively Impaired ◽  
Transition Care

scholarly journals Characteristics of patients receiving health assessments, care plans or case conferences by general practitioners, as part of the Enhanced Primary Care program between November 1999 and October 2001

2002 ◽  
Vol 25 (6) ◽  
pp. 120
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Indigenous People ◽  
Care Program ◽  
The Elderly ◽  
Care Plans ◽  
Department Of Health ◽  
Health Assessments ◽  
Case Conferences ◽  
Gender Patterns

We aimed to describe the characteristics of patients receiving health assessments (HA), care plans (CP) or case conferences (CC) through the Enhanced Primary Care (EPC) program between November 1999 and October 2001. The Commonwealth Department of Health and Ageing provided data. In all, 43%of non-Indigenous people who had a HA were aged 75-79 years and 32%were aged 80-84 years. Those having a HA at home were older (30.3% aged 85 years and above) than those having a HA in GP's rooms (20.2%85 years and above). For Indigenous people, between 12 and 17%of all HAs were done among each five-year age group between 55 and 84 years. As a group, CPs were mostly done among older people, with a higher proportion done among older women (74.2%among those 55 years and above) than older men (66.4%). Most CCs were also done among older people (60.4%55 years and above). Of the 286,250 people that had at least one EPC service, most (219,210; 76.6%)had only one. Of these, 153,624 (70.1%)had a HA. Of those having at least one EPC service, 95.7%had two services (most often a HA plus a CP). To date EPC activity has been concentrated among the elderly, gender patterns are similar, and few patients have received more than a single EPC service, which is usually a HA.

scholarly journals Framework Implementation of the INSPIRE ICOPE-CARE program in collaboration with the World Health Organization (WHO) in the Occitania region

2020 ◽  
pp. 1-7
Author(s):  
N. Tavassoli ◽  
A. Piau ◽  
C. Berbon ◽  
J. De Kerimel ◽  
C. Lafont ◽  
...  
Keyword(s):  
Older People ◽  
World Health Organization ◽  
Large Scale ◽  
Care Program ◽  
World Health ◽  
Psychological State ◽  
Digital Medicine ◽  
The World ◽  
Intrinsic Capacity ◽  
Health Organization

Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.

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