scholarly journals Multimorbidity and access to social Care: exploiting emerging administrative data sources in Scotland.

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
David Henderson ◽  
Nick Bailey ◽  
Colin McCowan ◽  
Stewart Mercer
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Policy Development ◽  
Service Use ◽  
Social Care ◽  
Information Service ◽  
Health Care Use ◽  
Long Term Conditions ◽  
Care Services ◽  
Health And Social Care

IntroductionIntegration of health and social care services is a potential solution to improving care despite budgetary constraints and increased demand for services. Little is known about how having two-or-more long-term conditions (multimorbidity) and socioeconomic status affect social care use, or how all these factors affect unscheduled health care use. Objectives and ApproachThe project aims to describe the demographic, geographic, and socioeconomic differences in the receipt of social care for over 65s in Scotland and how multimorbidity status influences amounts of social care received. Additional analyses will consider the influence receipt of social care has on use of unscheduled health care services and mortality. Social Care Survey (SCS) data collected by the Scottish Government is linked to administrative health and mortality records. Linkage includes; prescribing information service and USC data which records episodes of A & E attendance, emergency admission to hospital, GP out-of-hours attendance, Scottish Ambulance Service use, and NHS24 contact ResultsThe cohort includes 1.1million individuals over the age of 65 (54.8% Female), of which 274,011 (24.2%) people died during the study period. The linkage rate of the SCS to records with a CHI number in the National Records of Scotland population spine was 90.5%, with one local authority removed for very low linkage rates and the remaining 31 with rates between 76.7% and 97.9%. As of February 2018, all requested data has been transferred to the National Safe Haven and data cleaning and analysis has begun. Significant results are expected to have been produced by August 2018. Conclusion/ImplicationsThis research will help understand if receipt of social care is equitably distributed among the population of Scotland after allowing for multimorbidity and socioeconomic status. Understanding the influence health status has on social care receipt and the influence social care has on unscheduled healthcare use has important implications for policy development.

scholarly journals A review of integrated heart failure care

2018 ◽  
Vol 20 ◽  
Author(s):  
Julie MacInnes ◽  
Liz Williams
Keyword(s):  
Heart Failure ◽  
Professional Education ◽  
Social Care ◽  
Symptom Control ◽  
Developed Countries ◽  
Integrative Review ◽  
Cochrane Library ◽  
Long Term Conditions ◽  
Care Services ◽  
Health And Social Care

Abstract Aim The aim of this integrative review is to determine the effectiveness of integrated heart failure (HF) care in terms of patient-, service- and resource-related outcomes, and to determine what model or characteristics of integrated care work best, for whom and in what contexts. Background Integration of health and social care services is a significant driver in the development of better and more cost-effective health and social care systems in Europe and developed countries. As high users of health and social care services, considerable attention has been paid to the care of people with long-term conditions. HF is a progressive, prevalent and disabling condition, requiring complex management involving multiple health and social care agencies. Methods An integrative review was conducted according to a framework by Whittemore and Knafl (2005). A literature search was undertaken using the databases: Medline, CINAHL, Embase, PsychINFO and the Cochrane Library, using key words of ‘heart failure’ OR ‘cardiac failure’ AND ‘integrated’ OR ‘multidisciplinary’ OR ‘interdisciplinary’ OR ‘multiprofessional’ OR ‘interprofessional’ OR ‘collaborative care’. Application of the inclusion and exclusion criteria resulted in 17 articles being included in the review. Articles were screened and coded for methodological quality according to a two-point criteria. Data were extracted using a template and analysed thematically. Findings Integrated HF care results in enhanced quality of life (QoL), and improved symptom control and self-management. Reduced admission rates, reduced length of hospital stay, improved prescribing practices and better care co-ordination are also reported. There is more limited evidence for improved efficiency although overall costs may be reduced. Although findings are highly context dependent, key features of integrated HF models are: liaison between primary and secondary care services to facilitate planned discharge, early and medium term follow-up, multidisciplinary patient education and team working including shared professional education, and the development and implementation of comprehensive care pathways.

Virtual Communities in Health and Social Care

2010 ◽  
pp. 332-351 ◽  
Author(s):  
Maonolis Tsiknakis
Keyword(s):  
Health Care ◽  
Virtual Communities ◽  
Social Care ◽  
Care Delivery ◽  
Virtual Community ◽  
Science Research ◽  
Current Status ◽  
Ethical Challenges ◽  
Care Services ◽  
Health And Social Care

This chapter provides an overview and discussion of virtual communities in health and social care. The available literature indicates that a virtual community in health or social care can be defined as a group of people using telecommunications with the purposes of delivering health care and education, and/or providing support. Such communities cover a wide range of clinical specialties, technologies and stakeholders. Examples include peer-to-peer networks, virtual health care delivery and E-Science research teams. Virtual communities may empower patients and enhance coordination of care services; however, there is not sufficient systematic evidence of the effectiveness of virtual communities on clinical outcomes. When practitioners utilize virtual community tools to communicate with patients or colleagues they have to maximize sociability and usability of this mode of communication, while addressing concerns for privacy and the fear of de-humanizing practice, and the lack of clarity or relevance of current legislative frameworks. Furthermore, the authors discuss in this context ethical, legal considerations and the current status of research in this domain. Ethical challenges including the concepts of identity and deception, privacy and confidentiality and technical issues, such as sociability and usability are introduced and discussed.

Case Management for Long‐Term Conditions: The Role of Networks in Health and Social Care Services

2010 ◽  
Vol 18 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Jessica Abell ◽  
Jane Hughes ◽  
Siobhan Reilly ◽  
Kathryn Berzins ◽  
David Challis
Keyword(s):  
Case Management ◽  
Social Care ◽  
Long Term Conditions ◽  
Care Services ◽  
Health And Social Care

Virtual Communities in Health and Social Care

2011 ◽  
pp. 367-386
Author(s):  
Maonolis Tsiknakis
Keyword(s):  
Health Care ◽  
Virtual Communities ◽  
Social Care ◽  
Care Delivery ◽  
Virtual Community ◽  
Science Research ◽  
Current Status ◽  
Ethical Challenges ◽  
Care Services ◽  
Health And Social Care

This chapter provides an overview and discussion of virtual communities in health and social care. The available literature indicates that a virtual community in health or social care can be defined as a group of people using telecommunications with the purposes of delivering health care and education, and/or providing support. Such communities cover a wide range of clinical specialties, technologies and stakeholders. Examples include peer-to-peer networks, virtual health care delivery and E-Science research teams. Virtual communities may empower patients and enhance coordination of care services; however, there is not sufficient systematic evidence of the effectiveness of virtual communities on clinical outcomes. When practitioners utilize virtual community tools to communicate with patients or colleagues they have to maximize sociability and usability of this mode of communication, while addressing concerns for privacy and the fear of de-humanizing practice, and the lack of clarity or relevance of current legislative frameworks. Furthermore, the authors discuss in this context ethical, legal considerations and the current status of research in this domain. Ethical challenges including the concepts of identity and deception, privacy and confidentiality and technical issues, such as sociability and usability are introduced and discussed.

scholarly journals Does a social prescribing ‘holistic’ link-worker for older people with complex, multimorbidity improve well-being and frailty and reduce health and social care use and costs? A 12-month before-and-after evaluation

2019 ◽  
Vol 20 ◽  
Author(s):  
Julian Elston ◽  
Felix Gradinger ◽  
Sheena Asthana ◽  
Caroline Lilley-Woolnough ◽  
Sue Wroe ◽  
...  
Keyword(s):  
Older People ◽  
Service Use ◽  
Social Care ◽  
Patient Activation ◽  
Well Being ◽  
Long Term Conditions ◽  
Social Prescribing ◽  
Health And Social Care ◽  
Before And After ◽  
The Impact

Abstract Aim: To evaluate the impact of ‘holistic’ link-workers on service users’ well-being, activation and frailty, and their use of health and social care services and the associated costs. Background: UK policy is encouraging social prescribing (SP) as a means to improve well-being, self-care and reduce demand on the NHS and social services. However, the evidence to support this policy is generally weak and poorly conceptualised, particularly in relation to frail, older people and patient activation. Torbay and South Devon NHS Foundation Trust, an integrated care organisation, commissioned a Well-being Co-ordinator service to support older adults (≥50 years) with complex health needs (≥2 long-term conditions), as part of its service redesign. Methods: A before-and-after study measuring health and social well-being, activation and frailty at 12 weeks and primary, community and secondary care service use and cost at 12 months prior and after intervention. Findings: Most of the 86 participants achieved their goals (85%). On average health and well-being, patient activation and frailty showed a statistically significant improvement in mean score. Mean activity increased for all services (some changes were statistically significant). Forty-four per cent of participants saw a decrease in service use or no change. Thirteen high-cost users (>£5000 change in costs) accounted for 59% of the overall cost increase. This was largely due to significant, rapid escalation in morbidity and frailty. Co-ordinators played a valuable key-worker role, improving the continuity of care, reducing isolation and supporting carers. No entry-level participant characteristic was associated with change in well-being or service use. Larger, better conceptualised, controlled studies are needed to strengthen claims of causality and develop national policy in this area.

scholarly journals 532 CARING FOR AND CARING ABOUT OLDER PEOPLE LIVING WITH SEVERE FRAILTY DURING COVID-19

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
R Green ◽  
H King ◽  
C Nicholson
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Social Contact ◽  
Care Services ◽  
Poor Access ◽  
Health And Social Care ◽  
Video And Audio ◽  
The Impact

Abstract Introduction An ongoing study collected survey and interview data from older people with frailty living in the community near end-of-life during the Covid-19 pandemic. Methods Unstructured interviews with older people with frailty living in the community (N = 10), which included accounts from unpaid carers (N = 5), were video and audio recorded between October–November 2021. Six of these older people have died since fieldwork completion. A face-to-face survey collected data from a further 10 older people. Participants ages ranged from 70–99, 11, men, and 9 women, living in owned, rented, or sheltered accommodation, with Clinical Frailty Scores of 6 (N = 8), 7 (N = 9), and 8 (N = 3). Results Topics raised in relation to the pandemic included loss of social contact and increased loneliness, concern about not physically getting out, and losing physical function. Older people struggled to gain access to health and social care for support and previously received services were withdrawn. Most participants did not have access to internet and relied heavily on families to facilitate virtual contact with health professionals. Families and friends were the main anchor in facilitating social and health care including chasing up medications, liaising with social care to ensure quality and consistency of care provided, and monitoring older people’s health. Where older people’s conditions worsened family provided intense support, though family carers described the strain and unsustainability of this provision. Older people and their families felt they had been forgotten. Conclusions These are insights from hard-to-reach population that are frequently invisible. Greater examination of the impact of using communication technologies in care provision on those with poor access to and capabilities with using these technologies is required. Unpaid carers need more information and resources to support the care they provide and to facilitate access to appropriate social and health care services for those they care for.

scholarly journals In adults with multimorbidity, does the provision of social care services have an effect on the use of primary care and secondary care health services?

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
David Henderson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Secondary Care ◽  
Social Care ◽  
Grey Literature ◽  
Qualitative Synthesis ◽  
Delivery Of Care ◽  
Care Services ◽  
Health And Social Care ◽  
The Relationship

ABSTRACT ObjectivesHealth and social care is an area of high policy importance in the UK. Integration of health boards with local authority provided social care in Scotland in 2016 is a major structural change in delivery of care. Improvements in service and efficiency are expected and indeed required in an era of declining budgets.  Intuitively, health and social care are closely linked, particularly for those with multiple morbidities. However, little is known about the relationship between health and social care services and how usage of one has an impact on the other in terms of outcomes and costs. The study aims to describe the methods that have been used to analyse the relationship between social care, primary care and secondary care services. Findings will inform the analysis of a large linked dataset of health care, social care and benefits data that will investigate the interactions between health and social care, multimorbidity and socioeconomic status. ApproachA Scoping review of literature aiming to identify academic studies that have made an assessment of the relationship between health care and social care. A search of academic databases will be augmented by a search of grey literature aiming to identify the extent, range and nature of studies. Data will be extracted on populations, study designs, results and recommendations. Results will be visualised in charts alongside a descriptive qualitative synthesis. ResultsExpected June 2016

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