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Using intermediate care to strengthen healthcare delivery
- Authors:
- CLEGG Angie, McADAM Anne
- Journal article citation:
- Community Nurse, 7(3), April 2001, pp.25-26.
- Publisher:
- Emap Healthcare
Describes how an intermediate care initiative helped reduce bed pressures on the district hospital and improved the level of care delivered to patients.
A Patient Reported Experience Measure (PREM) for use by older people in community services
- Authors:
- TEALE E.A., YOUNG J.B.
- Journal article citation:
- Age and Ageing, 44(4), 2015, pp.667-672.
- Publisher:
- Oxford University Press
Background: Intermediate care (IC) services operate between health and social care and are an essential component of integrated care for older people. Patient Reported Experience Measures (PREMs) offer an objective measure of user experience and a practical way to measure person-centred, integrated care in IC settings. Objective: To describe the development of PREMs suitable for use in IC services and to examine their feasibility, acceptability and scaling properties. Setting: 131 bed-based and 143 home-based or re-ablement IC services in England. Methods: PREMs for each of home- and bed-based IC services were developed through consensus. These were incorporated into the 2013 NAIC and distributed to 50 consecutive users of each bed-based and 250 users of each home-based service. Return rates and patterns of missing data were examined. Scaling properties of the PREMs were examined with Mokken analysis. Results: 1,832 responses were received from users of bed-based and 4,627 from home-based services (return rates 28 and 13%, respectively). Missing data were infrequent. Mokken analysis of completed bed-based PREMs (1,398) revealed 8 items measuring the same construct and forming a medium strength (Loevinger H 0.44) scale with acceptable reliability (ρ = 0.76). Analysis of completed home-based PREMs (3,392 records) revealed a medium-strength scale of 12 items (Loevinger H 0.41) with acceptable reliability (ρ = 0.81). Conclusions: The two PREMs offer a method to evaluate user experience of both bed- and home-based IC services. Each scale measures a single construct with moderate scaling properties, allowing summation of scores to give an overall measure of experience. (Publisher abstract)
What is intermediate care: looking at needs
- Authors:
- ENDERBY Pam, STEVENSON Jan
- Journal article citation:
- Managing Community Care, 8(6), December 2000, pp.35-40.
- Publisher:
- Pavilion
Managing operational change using a whole-systems approach will be the key to re-engineering services, including intermediate care and rehabilitation for older people. This article outlines an approach used in Sheffield which is based on eight categories of need.
Intermediate care - responding to an exciting challenge
- Author:
- WITTON Marion
- Journal article citation:
- Caring Times, July 2000, p.16.
- Publisher:
- Hawker
The government says it is willing to involve independent providers in intermediate care. When change is in the air, the first consideration must always be the welfare of residents and patients.
Delayed discharge, a solvable problem?: the place of intermediate care in mental health care of older people
- Authors:
- PATON J. M., FAHY M. A., LIVINGSTONE G. A.
- Journal article citation:
- Aging and Mental Health, 8(1), January 2004, pp.34-39.
- Publisher:
- Taylor and Francis
The National Service Framework for Older People envisages the development of intermediate care for older people. This study examined the possible role of intermediate care beds within mental health trusts. We interviewed senior clinicians in an inner city old age psychiatry service about the 91 current in-patients on the old age psychiatric wards. Sixty-five were classified as acute patients and the remaining 26 were continuing care patients. Structured instruments were used to collect information regarding neuropsychiatric symptoms, activities of daily living and current met and unmet needs. Where discharge was delayed an assessment was made regarding the appropriateness for an intermediate care setting according to the criteria set by the Department of Health guidelines. A total of 30 (46%) patients' discharges were delayed. Of these, 19 (29%) patients met the DOH criteria for intermediate care; 10 (53%) had dementia, five (26%) affective disorder, and four (21%) with schizophrenia. The 11 other delayed discharges were because of lack of availability of finance for placements. The study found that the prompt discharge of older patients from acute psychiatric care was a significant problem and many of those patients may benefit from the therapeutic and rehabilitative process afforded by intermediate care.
Nursing homes in England and their capacity to provide rehabilitation and intermediate care services
- Authors:
- JACOBS Sally, RUMMERY Kirstein
- Journal article citation:
- Social Policy and Administration, 36(7), December 2002, pp.735-752.
- Publisher:
- Wiley
The numbers of older people living in residential and nursing home care in the UK have risen exponentially since the early 1980s when the closure of long-stay geriatric wards and changes in social security funding of care home places led to a rapid expansion of the care home industry. While the implementation of the 1990 National Health Service (NHS) and Community Care Act shifted the responsibility for the commissioning and funding of these services to local authority social services departments, the provision of most health services (such as general practitioner care, physiotherapy and specialist nursing services) to nursing home residents remains the responsibility of community-based NHS practitioners. Recently, the attention of policy-makers in the UK has been focused on the need to improve the throughput of the acute sector. Older people who have received treatment but are not yet able to return to their own homes are to be transferred into intermediate care facilities, often by using nursing home beds, with the aim of supporting short-term rehabilitation outside of the acute sector. This paper presents evidence from a study of health service provision to older people living in nursing homes in England. It examines whether nursing homes have the capacity to fulfil the rehabilitation and intermediate care function envisaged by policy-makers. It concludes that shortfalls in the provision of NHS services to nursing homes and difficulties faced by nursing homes in paying for health services themselves may hinder the rehabilitation potential of intermediate care placements in nursing homes.