Effectiveness of a health and social care integration programme for home-dwelling frail older persons in Argentina

IntroductionThe evidence of effectiveness of integrated care initiatives for home-dwelling frail older persons is still inconclusive. There is a need for more studies, especially in developing countries. Our objective was to assess the effectiveness of a health and social care integration programme...

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Published in:International journal of integrated care 2022-04, Vol.22 (S1), p.190
Main Authors: Perman, Gastón, Prevettoni, Mariana, Guenzelovich, Tami, Schapira, Marcelo, Infantino, Verónica Martínez, Ramos, Roxana, Saimovici, Javier, Gallo, Cristian M, Ferré Cunha, Maria Florencia, Scozzafava, Silvana, Hornstein, Lucila, Garfi, Leronardo
Format: Article
Language:English
Subjects:
Clinical trials
Integrated delivery systems
Older people
Patient admissions
Quality of life
Standard of care
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Summary:IntroductionThe evidence of effectiveness of integrated care initiatives for home-dwelling frail older persons is still inconclusive. There is a need for more studies, especially in developing countries. Our objective was to assess the effectiveness of a health and social care integration programme versus the best standard of care to date in this population.Theory/MethodsQuasi-experimental study performed in patients' homes in Buenos Aires, Argentina. The intervention arm had a health and social care counsellor that systematically reviewed the social and biological situation following a structured process, evaluating: functionality, nutrition, mobility, pain, cognition, medication reconciliation and adherence, need for care, quality of care, and environmental safety. The control group received the best standard of care to date, with access to the same health or social care services, but without the counsellor and related processes. The main outcome was the adjusted hazard ratio for hospitalizations after one year using a Cox-proportional hazards model.ResultsWe recruited 121 persons in each group. The crude hazard ratio for hospital admissions, comparing the intervention to the control group was 0.622 (95% CI 0.427 to 0.904; p 0.013). The adjusted hazard ratio (aHR) was 0.503 (95%CI 0.340 to 0.746; p 0.001). The aHR for death was 0.993 (95%CI 0.492 - 2.002; p 0.984). The absolute difference in the quality of life was 16.59 points (95%CI 12.03 to 21.14; p
ISSN:1568-4156
1568-4156
DOI:10.5334/ijic.ICIC21152