scholarly journals The direct cost of disability of community-dwelling older persons in Belgium

2020 ◽  
pp. 1-28
Author(s):  
Sophie Cès ◽  
Anne-Sophie Lambert ◽  
Johanna de Almeida Mello ◽  
Anja Declercq ◽  
Niko Speybroeck ◽  
...  
Keyword(s):  
Informal Care ◽  
Older Persons ◽  
Community Dwelling ◽  
Service Utilisation ◽  
Elderly Persons ◽  
Total Cost ◽  
Formal Support ◽  
Disabled Elderly ◽  
The Cost ◽  
At Home

Abstract Current policies aim to promote and develop community-based support of disabled elderly persons, yet knowledge of the cost implications is insufficient. Thus, we aimed to estimate, for three disability profiles and three presence levels of the main informal carer (none, non-cohabitant, cohabitant), the cost of formal and informal support currently provided at home in Belgium. In this cross-sectional study, a sample of 5,642 disabled elderly persons living at home was established between 2010 and 2016. The administrative database of the Belgian public healthcare insurance was merged with other prospective data on social care service utilisation, informal care and disability. The total cost of formal support ranged from €725 to €1,344 (on average, per person, per month), depending on the three disability profiles identified. Twenty-five per cent of persons with the highest level of disability (important functional limitations and cognitive impairment) and helped by a cohabitant carer, had a low total cost of formal support: below €382 per month. Informal care represented the main cost component of total support costs in the three disability profiles (between 64 and 76%). To prevent the worsening of situations of disabled older persons and their informal carers, better detection of seriously disabled persons with low levels of formal support is crucial.

Cost-effectiveness of home telemedical cardiotocography compared with traditional outpatient monitoring

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 69-70 ◽  
Author(s):  
Miklós Tõrõk ◽  
Ferenc Kovács ◽  
József Doszpod
Keyword(s):  
Outpatient Clinic ◽  
Home Monitoring ◽  
Total Cost ◽  
Patient Travel ◽  
Obstetrics And Gynaecology ◽  
Passive Sensor ◽  
The Cost ◽  
The University ◽  
Monitoring Service ◽  
At Home

We compared the cost of passive sensor telemedical non-stress cardiotocography performed at home and the same test performed by traditional equipment in an outpatient clinic in the Budapest area. The costs were calculated using two years’ registered budget data from the home monitoring service in Budapest and the outpatient clinic of the department of obstetrics and gynaecology at the Haynal Imre University of Health Sciences. The traditional test at the university outpatient clinic cost 3652 forint for the health-care and 1000 forint in additional expenses for the patient (travel and time off work). This means that the total cost for each test in the clinic was 4652 forint. The cost of home telemedical cardiotocography was 1500 forint per test, but each test took 2.1 times as long. For a more realistic comparison between the two methods, we adjusted the cost to take account of the extra length of time that home monitoring required. The adjusted cost for home care was 3150 forint, some 32% lower than in the clinic. Passive sensor telemedical non-stress cardiotocography at home was therefore less expensive than the same test performed in the traditional way in an outpatient clinic.

scholarly journals A System of Integrated Care for Older Persons With Disabilities in Canada: Results From a Randomized Controlled Trial

2006 ◽  
Vol 61 (4) ◽  
pp. 367-373 ◽  
Author(s):  
François Béland ◽  
Howard Bergman ◽  
Paule Lebel ◽  
A. Mark Clarfield ◽  
Pierre Tousignant ◽  
...  
Keyword(s):  
Nursing Home ◽  
Integrated Care ◽  
Social Services ◽  
Caregiver Burden ◽  
Older Persons ◽  
Controlled Trial ◽  
Full Range ◽  
Community Dwelling ◽  
Elderly Persons ◽  
Persons With Disabilities

Abstract Background. Care for elderly persons with disabilities is usually characterized by fragmentation, often leading to more intrusive and expensive forms of care such as hospitalization and institutionalization. There has been increasing interest in the ability of integrated models to improve health, satisfaction, and service utilization outcomes. Methods. A program of integrated care for vulnerable community-dwelling elderly persons (SIPA [French acronym for System of Integrated Care for Older Persons]) was compared to usual care with a randomized control trial. SIPA offered community-based care with local agencies responsible for the full range and coordination of community and institutional (acute and long-term) health and social services. Primary outcomes were utilization and public costs of institutional and community care. Secondary outcomes included health status, satisfaction with care, caregiver burden, and out-of-pocket expenses. Results. Accessibility was increased for health and social home care with increased intensification of home health care. There was a 50% reduction in hospital alternate level inpatient stays (“bed blockers”) but no significant differences in utilization and costs of emergency department, hospital acute inpatient, and nursing home stays. For all study participants, average community costs per person were C$3390 higher in the SIPA group but institutional costs were C$3770 lower with, as hypothesized, no difference in total overall costs per person in the two groups. Satisfaction was increased for SIPA caregivers with no increase in caregiver burden or out-of-pocket costs. As expected, there was no difference in health outcomes. Conclusions. Integrated systems appear to be feasible and have the potential to reduce hospital and nursing home utilization without increasing costs.

Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services

2011 ◽  
Vol 52 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Masafumi Kuzuya ◽  
Jun Hasegawa ◽  
Yoshihisa Hirakawa ◽  
Hiromi Enoki ◽  
Sachiko Izawa ◽  
...  
Keyword(s):  
Informal Care ◽  
Community Dwelling ◽  
Community Based ◽  
Dependent Elderly ◽  
Community Based Services ◽  
At Home

The Service Needs of Older People: Implications for Public Policy

1985 ◽  
Vol 4 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Ingrid Connidis
Keyword(s):  
Public Policy ◽  
Older People ◽  
Random Sample ◽  
Support Services ◽  
Older Persons ◽  
Service Providers ◽  
Community Services ◽  
Community Dwelling ◽  
Service Needs ◽  
Formal Support

ABSTRACTIn this paper the service needs of community-dwelling older persons are examined. Based on the responses from a random sample of 400 residents aged 65 and over, it is found that just over 9 percent of this population is currently using or in need of community services. Thus, the vast majority of older persons are managing without the aid of formal support services. The importance of the seemingly modest proportion of older persons requiring services is discussed. The consequences for public policy of anticipated constraints on family and women as service providers in the future are emphasized.

Caregiving for Community-Dwelling Older Persons in South Korea: Current Formal and Informal Care Use and Expectation

2019 ◽  
Vol 39 (4) ◽  
pp. 398-403 ◽  
Author(s):  
Eunja Park ◽  
Namsoon Kim ◽  
Van M. Ta Park ◽  
YongJoo Rhee
Keyword(s):  
Informal Care ◽  
Older Persons ◽  
Community Dwelling ◽  
Formal Care ◽  
Term Care ◽  
Emergency Department Use ◽  
Care Recipients ◽  
To Receive ◽  
Care Support

The aim of this study is to examine formal and informal care use among community-dwelling older Korean adults. Older adults aged between 65 and 85 ( N = 516) in mid-size city, selected using the probability proportional sampling method, were interviewed in person. One third reported having at least one caregiver. Compared to respondents who did not use any informal/formal care, those who used any formal or informal care were older and were more likely to be prefrail or frail and experienced at least one hospitalization or emergency department use in the past year. Living alone or being experienced with any hospitalization was associated with formal care use. Most care recipients received informal care from families, specifically spouses. Among participants who received no formal/informal care, 19% of them expected to receive formal care support in the future. Substantial support programs for informal caregivers are needed to address the increase in demand and expectation for long-term care.

The Case of Thematic Tests Adapted to Older Adults

2011 ◽  
Vol 32 (1) ◽  
pp. 46-71 ◽  
Author(s):  
Benoît Verdon
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
Older Men ◽  
Elderly Persons ◽  
Mental Processes ◽  
Men And Women ◽  
Projective Tests ◽  
New Material ◽  
Older Men And Women ◽  
Latent Content

Since the 1950s, the growing interest of clinicians in using projective tests to study normal or pathological aging processes has led to the creation of several thematic tests for older adults. This development reflects their authors’ belief that the TAT is not suitable to the concerns and anxieties of elderly persons. The new material thus refers explicitly to situations related to age; it aims to enable older persons to express needs they cannot verbalize during consultations. The psychodynamic approach to thematic testing is based on the differentiation between the pictures’ manifest and latent content, eliciting responses linked to mental processes and issues the respondent is unaware of. The cards do not necessarily have to show aging characters to elicit identification: The situations shown in the pictures are linked to loss, rivalry, helplessness, and renunciation, all issues elderly respondents can identify with and that lead them to express their mental fragilities and resources. The article first explains the principles underlying four of these thematic tests, then develops several examples of stories told for card 3BM of the TAT, thus showing the effectiveness of this tool for the understanding and differentiation of loss-related issues facing older men and women.

The impact of functional limitations on disability and the moderating effects of psychological attributes in community-dwelling older persons

1998 ◽  
Author(s):  
G. I. J. M. Kempen ◽  
M. J. G. van Heuvelen ◽  
E. van Sonderen ◽  
R. H. S. van den Brink ◽  
A. C. Kooijman ◽  
...  
Keyword(s):  
Older Persons ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Moderating Effects ◽  
Psychological Attributes ◽  
The Impact

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

Sign in / Sign up

Export Citation Format

Share Document