Health services for the aged
June 20, 2012
Introduction:
This discussion paper is the outcome of a think tank session the Canadian Working Group on HIV and Rehabilitation hosted in March 2011. It outlines issues of access to rehabilitation services for people living with complex chronic and episodic conditions1, promotes discussion on appropriate and timely services, and identifies opportunities for policy-makers and clinicians to consider issues related to chronic conditions and episodic disabilities and to take action to address these issues.
Posted in READ Portal, Working Papers | Tagged with Chronic disease, Health services for the aged, Quality improvement | No Comments
May 17, 2012
“Key messages:
Continuity is fundamental to high-quality care. Without it, care is unlikely to be clinically effective, safe, personalised, efficient or cost-effective. Breakdowns in continuity of care put patients at risk, cause duplication and add avoidable costs to both health and social care.
This paper focuses on the experiences of older people with multiple health problems, and particularly on their experiences inside hospital. Continuity is especially important for these older patients because: they are more likely to spend time in hospital and to be in hospital for longer; if they are frail, a stay in hospital can be life-changing; and, regrettably, in some hospitals and some wards older patients are exposed to unacceptable standards of care….”
Posted in READ Portal, Reports & Papers | Tagged with Health services for the aged, Hospitals, Patient-centered care, Quality of care | No Comments
April 26, 2012
“In this report, we focus on the issues and challenges related to home care for seniors and their caregivers in Canada, and the opportunities to improve and integrate the services they need to age well at home.
We begin by looking at the types of clients who are receiving home care, the services they are receiving, and the intensity of their needs. We then look at the characteristics of family caregivers, including the number of hours they spend on care and their level of distress. In particular, our analyses show that many seniors with complex and multiple health needs are receiving limited hours of home care, and as a consequence a considerable number of their family caregivers—many of whom are seniors themselves—are stretched beyond their capacity and report high levels of distress.
We also examine system issues such as the importance of integrating home care with hospitals and primary care, and the challenges facing the home care sector such as the recruitment and retention of personal support workers. We discuss the cost-effectiveness of home care compared to hospital care and long-term care facilities, noting that public spending on long-term care facilities in Canada is much higher than spending on home and community care. We look at the experiences of other countries that spend proportionally more on home care and have implemented strategies to ensure that seniors can remain at home longer with a better quality of life.
Throughout the report, we profile innovative practices that are examples of effective home care policies and programs, and that illustrate how home care can be integrated with other health services and sectors. These practices offer tools and ideas that can be adapted by governments and health systems across Canada.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health services for the aged | No Comments
January 24, 2012
“Background: The risk of infection following a visit to the emergency department is unknown. We explored this risk among elderly residents of long-term care facilities.
Methods: We compared the rates of new respiratory and gastrointestinal infections among elderly residents aged 65 years and older of 22 long-term care facilities. We used standardized surveillance definitions. For each resident who visited the emergency department during the study period, we randomly selected two residents who did not visit the emergency department and matched them by facility unit, age and sex. We calculated the rates and proportions of new infections, and we used conditional logistic regression to adjust for potential confounding variables.
Results: In total, we included 1269 residents of long-term care facilities, including 424 who visited the emergency department during the study. The baseline characteristics of residents who did or did not visit the emergency department were similar, except for underlying health status (visited the emergency department: mean Charlson Comorbidity Index 6.1, standard deviation [SD] 2.5; did not visit the emergency department: mean Charlson Comorbidity index 5.5, SD 2.7; p < 0.001) and the proportion who had visitors (visited the emergency department: 46.9%; did not visit the emergency department: 39.2%; p = 0.01). Overall, 21 (5.0%) residents who visited the emergency department and 17 (2.0%) who did not visit the emergency department acquired new infections. The incidence of new infections was 8.3/1000 patient-days among those who visited the emergency department and 3.4/1000 patient-days among those who did not visit the emergency department. The adjusted odds ratio for the risk of infection following a visit to the emergency department was 3.9 (95% confidence interval 1.4–10.8).
Interpretation: A visit to the emergency department was associated with more than a threefold increased risk of acute infection among elderly people. Additional precautions should be considered for residents following a visit to the emergency department.”
Posted in Journal Articles, READ Portal | Tagged with Health services for the aged, Infection control, Prevention and control, Safety | No Comments
January 18, 2012
In 2011, the fi rst members of Canada’s baby boom generation will turn age 65.
It is predicted that as early as 2015, seniors (those age 65 and older) will
outnumber youth (those age 14 and younger). Concerns have been raised
that Canada’s health care system will be unable to meet the growing health
care needs of this aging population. Seniors are typically frequent users of
health care services, with the system spending more on them than on any
other segment of the population. Federal, provincial and territorial governments
have all recognized the importance of improving services for seniors. Making
any such improvements fi rst requires an understanding of this diverse and
complex population. Health Care in Canada, 2011: A Focus on Seniors and
Aging describes seniors’ specifi c needs and the particular ways in which this
population uses the health care system. From this perspective, the report
examines the impact of a growing seniors population on Canada’s health
care system.
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health services for the aged | No Comments
December 14, 2011
“Background: Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting. Our study goal was to determine whether there is an association between facility ownership and the frequency of nursing home complaints.
Methods: We analyzed publicly available data on complaints, regulatory measures, facility ownership and size for 604 facilities in Ontario over 1 year (2007/08) and 62 facilities in British Columbia (Fraser Health region) over 4 years (2004–2008). All analyses were carried out at the facility level. Negative binomial regression analysis was used to assess the association between type of facility ownership and frequency of complaints.
Interpretation: Compared with for-profit chain facilities, non-profit, charitable and public facilities had significantly lower rates of complaints in Ontario. Likewise, in British Columbia’s Fraser Health region, non-profit owned facilities had significantly lower rates of complaints compared with for-profit owned facilities.”
Click here to read the full article
Posted in Journal Articles, READ Portal | Tagged with Health services for the aged, Quality assessment, Quality of care | No Comments
November 24, 2011
“Aging is an important women’s health issue. Canada’s aging population is presenting unique challenges to the health system on multiple fronts. Women comprise the majority of the older population and have different patterns of illness and health needs than men. In 2005, 13% of the Canadian population was aged 65 or older, and this number is projected to increase to more than 25% by 2056. Older adults have a high burden of chronic disease and multiple chronic conditions requiring a patient-centred (rather than a disease-specific) approach to their care. Both social and biological factors result in important differences in the health and the health care needs of older women and men. Older women are more likely to have a greater burden of illness including multiple chronic conditions, more functional limitations, and a higher prevalence of disability then older men. Therefore, the mismatch between the way health and supportive care services are organized and the needs of older adults disproportionately impacts women.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Canada, Forecasting, Health services for the aged, Patient-centered care | No Comments
September 12, 2011
On the surface, technology-enabled home health care should be thriving in the United States. The country’s aging population and the transformation of acute illnesses such as heart failure into chronic diseases mean that the number of patients is growing. In addition, new medical-technology devices could help keep patients at home rather than in costly institutions, such as assisted-living facilities or nursing homes—leading to potentially big savings for the health care system.
Instead, the full potential of the technology-enabled home health care market remains to be tapped.
Click here for the full article
Posted in Journal Articles, READ Portal | Tagged with Health services for the aged, Technology | No Comments
August 10, 2011
“Concern about chronic condition care is growing as the prevalence of chronic conditions such as diabetes and high blood pressure increases in Canada.1 For many chronic conditions, prevalence increases with age, causing a disproportionate health burden on seniors—Canadians age 65 and older.2 Patients with chronic conditions—in particular multiple chronic conditions, also called comorbidity—typically have poorer quality of life and require considerable health care resources. Effective prevention and management of chronic conditions is required, especially in the face of Canada’s large boomer generation entering the senior age category.
This study examined the reported experiences of seniors in Canada being treated for chronic conditions in primary health care (PHC) settings. The results of the study can be used to enhance our understanding of patients’ use of health care services and health status, the quality of patient–provider communication, patient self- management and medication management. This report is focused on seniors because they are more likely than younger people to have chronic conditions, especially comorbidities that can be complex and difficult to manage.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health care costs, Health services for the aged | No Comments
June 15, 2011
“Recent investments by the Ontario Ministry of Health and Long-Term Care (MOHLTC) engaged Local Health Integration Networks (LHINs) and other health and community support organizations to deliver innovative, community-based care with the dual goals of enabling seniors to live safely in their own homes and alleviating related pressures on more costly care settings, such as acute care hospitals and long-term care homes.
This Chartbook allows for visual comparisons of health system data analyzed over time and geographically by LHIN, as well as a comparison of several population characteristics including age, sex, income quintile, immigration status and frailty. The Chartbook reports on a set of key indicators vital to older adults, including emergency department visits, use of alternate level of care beds in hospitals, waiting times for long-term care home placement and home care services and self-perceived unmet home services care needs.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health planning, Health services for the aged | No Comments
