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The effectiveness of the PRISMA integrated service delivery network: preliminary report on methods and baseline data
- Authors:
- HERBET Rejean, et al
- Journal article citation:
- International Journal of Integrated Care, 8(1), 2008, Online only
- Publisher:
- International Foundation for Integrated Care
The PRISMA study analyzes an innovative coordination-type integrated service delivery (ISD) system developed to improve continuity and increase the effectiveness and efficiency of services, especially for older and disabled populations. The objective of the PRISMA study is to evaluate the effectiveness of this system to improve health, empowerment and satisfaction of frail older people, modify their health and social services utilization, without increasing the burden of informal caregivers. The objective of this paper is to present the methodology and give baseline data on the study participants. A quasi-experimental study with pre-test, multiple post-tests, and a comparison group was used to evaluate the impact of PRISMA ISD. Elders at risk of functional decline (501 experimental, 419 control) participated in the study. At entry, the two groups were comparable for most variables. Over the first year, when the implementation rate was low (32%), participants from the control group used fewer services than those from the experimental group. After the first year, no significant statistical difference was observed for functional decline and changes in the other outcome variables. This first year must be considered a baseline year, showing the situation without significant implementation of PRISMA ISD systems. Results for the following years will have to be examined with consideration of these baseline results.
Aging gracefully: the PACE approach to caring for frail elders in the community
- Authors:
- HOSTETTER Martha, KLEIN Sarah, McCARTHY Douglas
- Publisher:
- Commonwealth Fund
- Publication year:
- 2016
- Pagination:
- 14
- Place of publication:
- New York
Focusing on the original programme of On Lok operating in one area of the USA, this case study examines the Program of All-Inclusive Care for the Elderly (PACE) model of care and explores the potential for the model to be adapted for use with a wider population. The PACE model serves a target population of people age 55 and older, who need long-term care but are able to safely live at home. Key features of the programme include: comprehensive medical and social services delivered in community day centres and people’s homes; care coordination by interdisciplinary teams, and integrated care through to end of life. The service promotes socialisation, activity, and independence, while lessening burden on family caregivers. Evaluation estimates that the service improves some aspects of care quality and reduces need for acute care, while achieving costs comparable to traditional Medicare. Challenges identified include that it is operationally complex and also requires large care teams. It also may need some adaptation to reach larger share of population. This is one of a series of case studies examining programs in the United States that aim to improve outcomes and reduce costs of care for patients with complex needs. (Edited publisher abstract)
The social work role in reducing 30-day readmissions: the effectiveness of the Bridge Model of transitional care
- Authors:
- ALVAREZ Renae, et al
- Journal article citation:
- Journal of Gerontological Social Work, 59(3), 2016, pp.222-227.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The hospital experience is taxing and confusing for patients and their families, particularly those with limited economic and social resources. This complexity often leads to disengagement, poor adherence to the plan of care, and high readmission rates. Novel approaches to addressing the complexities of transitional care are emerging as possible solutions. The Bridge Model is a person-centred, social work-led, interdisciplinary transitional care intervention that helps older adults safely transition from the hospital back to their homes and communities. The Bridge Model combines 3 key components - care coordination, case management, and patient engagement - which provide a seamless transition during this stressful time and improve the overall quality of transitional care for older adults, including reducing hospital readmissions. The post Affordable Care Act (ACA) and managed care environment’s emphasis on value and quality support further development and expansion of transitional care strategies, such as the Bridge Model, which offer promising avenues to fulfil the triple aim by improving the quality of individual patient care while also impacting population health and controlling per capita costs. (Edited publisher abstract)
Sustainability processes among Naturally Occurring Retirement Community Supportive Service Programs
- Authors:
- GREENFIELD Emily A., FRANTZ Mandy E.
- Journal article citation:
- Journal of Community Practice, 24(1), 2016, pp.38-55.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philapelphia, USA
Sustainability remains a concern for community models to better support older adults’ ageing in place in their own homes and communities. Based on qualitative data from leaders of 53 Naturally Occurring Retirement Community (NORC) Supportive Service Programs, which is among the most prominent community practice models in ageing, the authors aimed to develop an empirically-grounded framework on sustainability processes. Results indicated that programmes use funding, staff members, interorganisational partnerships, and volunteers to offer services to attract older adults, and that older adults’ participation, in turn, is perceived as influencing the accrual of additional resources. Across themes, respondents discussed the importance of being responsive to the community and facilitating consumer participation. (Edited publisher abstract)
Evaluation of the implementation of PRISMA a coordinated-type integrated service delivery system for frail older people in Quebec
- Authors:
- HEBERT Rejean, et al
- Journal article citation:
- Journal of Integrated Care, 16(6), December 2008, pp.4-14.
- Publisher:
- Emerald
PRISMA is the only example of a co-ordinated type model to be developed and fully implemented with a process and outcome evaluation. This model uses all the public, private or voluntary health and social service organisations involved in caring for older people in a given area. Every organisation keeps its own structure, but agrees to participate in an umbrella system and adapt its operations to the agreed requirements and processes. The PRISMA model was implemented in three areas (urban, rural with or without a local hospital) in Quebec, Canada and an implementation evaluation was carried out using mixed (qualitative and quantitative) methods. Over four years, the implementation rates went from 22% to 79%. The perception of integration by managers and clinicians working in the various organisations of the network shows that most interactions are perceived as at the co-operation level, some getting the highest collaboration level. The perception of the efficacy of case managers was very high. Implementing such a model is feasible, and the decision to generalise it was made in Quebec. This model might be more appropriate for a universal publicly funded health care system like those in Canada, the UK and the Scandinavian countries.
Age Concerns: innovation through care management
- Author:
- STOESZ David
- Journal article citation:
- Journal of Aging and Social Policy, 14(3/4), 2002, pp.245-260.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Age Concerns is a proprietary care management firm serving the elderly. Established in 1982, the firm has prospered by employing an integrated model of care whereby the caregivers are employees of Age Concerns. In addition, the firm's ability to keep the elderly at home, out of institutional care, has resonated with consumers. Various features of Age Concerns-organisational format, characteristics of consumers, and economic considerations, are described. In 2001, Age Concerns was acquired by the Senior Care Action Network, a social health maintenance organisation. In an increasingly commercial environment in which the elderly are a burgeoning market, Age Concerns may be a prototype of future elder-care service delivery. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Care for the future
- Authors:
- TIDBALL Mike, ROBINSON James
- Journal article citation:
- Local Government Chronicle, 19.2.99, 1999, pp.16-17.
- Publisher:
- Emap Business
Looks at the current situation in care homes for the elderly, which the article argues, face a bleak future unless they take a new look at their services.
Deprivation indexes: do they measure up?
- Author:
- CUBEY David
- Journal article citation:
- Research Policy and Planning, 17(2), 1999, pp.23-32.
- Publisher:
- Social Services Research Group
How to allocate or target resources to those most in need of services has been of central concern to social services departments over the past 20 years. The focus of this article is the identification of a valid and reliable model to allocate social services resources to the elderly population in East Sussex. The model operationalises at District level and combines the results with those obtained from operationalising a synthetic model of the levels of disability in the elderly population. It is argued that this model can be validly and reliably applied to other local authorities.
A model village
- Author:
- TISSIER Gerry
- Journal article citation:
- Community Care, 29.4.93, 1993, p.20.
- Publisher:
- Reed Business Information
Devon SSD is investing in four Community Care Support Centres to replace residential care for elderly people. It is the philosophy of the centres to help elderly people return to or stay in their own or small-scale homes. Looks at how the project is being put into place.
Delivering unique care: care co-ordination in practice
- Author:
- ADAM Ruth
- Journal article citation:
- Journal of Integrated Care, 14(2), April 2006, pp.37-47.
- Publisher:
- Emerald
The National Primary Care Development Team (NPDT) is spreading the unique care approach to case management across the country. This article presents a case study of how Brent is successfully implementing unique care through the care co-ordination service. It aims to outline key steps in the development of the service, moving from the initial vision, to pilot phase and on to mainstreaming of the service. The collaborative methodology was adopted. The evidence suggests impressive reductions in service use, alongside an increase in quality of life and improved perception of health and social care services among older people who have had contact with the team.