scholarly journals The impact of community paramedicine interventions on Transfers from Long Term Care to Emergency Departments: A systematic review

2021 ◽  
Author(s):  
Abraham Munene ◽  
Dominic Alaazi ◽  
Jane Mathew ◽  
Patrick McLane ◽  
Greta Cummings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Departments ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Community Paramedicine ◽  
Review Articles ◽  
System P ◽  
The Impact

OBJECTIVES: Long term care (LTC) facilities are essential in the provision of daily care needs for older adults experiencing frailty. In times of acute medical distress, LTC residents may require transfer to emergency departments (ED). However, many transfers from the LTC to ED may not be required and residents could instead be treated within LTC utilizing community paramedics (CP). We conducted a systematic review to assess the impact of community paramedicine on the frequency of resident transfer from LTC to ED. METHODS: We searched five electronic databases (Medline, CINAHL, PubMed, Embase, and Cochrane). The search was limited to primary peer-reviewed publications and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and articles published within the last 30 years. RESULTS: A total of 19,308 titles and abstracts were screened with a total of 181 full text reviews. One study that comprised of 4 articles was included in the review that evaluated the impact of community paramedic interventions in LTC. The study noted a reduction in transfers to the ED attributed to the presence of CP, reducing transports to ED by nearly 30%. CONCLUSIONS: There is a scarcity of research examining the role of CP in LTC. While the current research points towards CP interventions in LTC reducing the number of transfers to ED, further research needs to be conducted on the effectiveness of community paramedicine interventions in improving health outcomes for residence and improving cost efficiency within the health system.

scholarly journals COVID-19 related mortality and spread of disease in long-term care: a living systematic review of emerging evidence

2020 ◽  
Author(s):  
Maximilian Salcher-Konrad ◽  
Arnoupe Jhass ◽  
Huseyin Naci ◽  
Marselia Tan ◽  
Yousef El-Tawil ◽  
...  
Keyword(s):  
Systematic Review ◽  
Long Term Care ◽  
Case Fatality ◽  
Mortality Rates ◽  
Primary Data ◽  
Research Database ◽  
Term Care ◽  
The Impact ◽  
Related Mortality

AbstractBackgroundPolicy responses to mitigate the impact of the COVID-19 pandemic on long-term care (LTC) require robust and timely evidence on mortality and spread of the disease in these settings. The aim of this living systematic review is to synthesise early international evidence on mortality rates and incidence of COVID-19 among people who use and provide LTC.MethodsWe report findings of a living systematic review (CRD42020183557), including studies identified through database searches up to 5 June 2020. We searched seven databases (MEDLINE; Embase; CINAHL Plus; Web of Science; Global Health; WHO COVID-19 Research Database; medRxiv) to identify all studies reporting primary data on COVID-19 related mortality and incidence of disease among LTC users and staff. We excluded studies not focusing on LTC. Included primary studies were critically appraised and results on number of deaths and COVID-19 related mortality rates, case fatality rates, and excess deaths (co-primary outcomes), as well as incidence of disease, hospitalisations, and ICU admissions were synthesised narratively. We further included official figures on number of deaths in LTC.FindingsA total of 33 study reports for 30 unique primary studies or outbreak reports were included. Outbreak investigations in LTC facilities found COVID-19 incidence rates of between 0.0% and 71.7% among residents and between 1.5% and 64.0% among staff. Mortality rates varied from 0.0% to 9.5% of all residents at outbreak facilities, with case fatality rates between 0.0% and 33.7%. In included studies, no LTC staff members had died. LTC residents accounted for between 0% (Hong Kong) and 85% (Canada) of COVID-related deaths, according to official figures.InterpretationLong-term care users have been particularly vulnerable to the COVID-19 pandemic. However, we found wide variation in spread of disease and mortality rates between outbreaks at individual LTC facilities. Further research into the factors determining successful prevention and containment of COVID-19 outbreaks is needed to protect long-term care users and staff.FundingThis work was partially conducted as part of the “Strengthening responses to dementia in developing countries” (STRiDE) project, supported by the UK Research and Innovation’s Global Challenges Research Fund (ES/P010938/1). The funders had no role in the design and execution of this study, interpretation of its results, and decision to submit this work to be published.

Reducing preventable patient transfers from long-term care facilities to emergency departments: a scoping review

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 844-856 ◽  
Author(s):  
Kiran L. Grant ◽  
Daniel Dongjoo Lee ◽  
Ivy Cheng ◽  
G. Ross Baker
Keyword(s):  
Health Care ◽  
Emergency Departments ◽  
Long Term Care ◽  
Term Care ◽  
Patient Transfers ◽  
Effective Interventions ◽  
Care Facilities ◽  
Ed Crowding ◽  
The Impact

ABSTRACTBackgroundIn Canada, there were over 60,000 long-term care facility patient transfers to emergency departments (EDs) in 2014, with up to a quarter of them being potentially preventable. Each preventable transfer exposes the patient to transport- and hospital-related complications, contributes to ED crowding, and adds significant costs to the health care system. There have been many proposed and studied interventions aimed at alleviating the issue, but few attempts to assess and evaluate different interventions across institutions.MethodsA systematic search of MEDLINE, CINAHL, and EMBASE for studies describing the impact of interventions aimed at reducing preventable transfers from long-term care facilities to EDs on ED transfer rate. Two independent reviewers screened the studies for inclusion and completed a quality assessment. A tabular and narrative synthesis was then completed. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines.ResultsA total of 26 studies were included (Cohen's k = 0.68). One was of low quality (Cohen's k = 0.58). Studies were summarized into five themes based on intervention type: Telemedicine, Outreach Teams, Interdisciplinary Care, Integrated Approaches, and Other. Effective interventions reported reductions in ED transfer rates post intervention ranging from 10 to 70%. Interdisciplinary health care teams staffed within long-term care facilities were the most effective interventions.ConclusionThere are several promising interventions that have successfully reduced the number of preventable transfers from long-term care facilities to EDs in a variety of health care settings. Widespread implementation of these interventions has the potential to reduce ED crowding in Canada.

scholarly journals Long-Term Care Preferences and Sexual Orientation: Protocol for a Systematic Review

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 572
Author(s):  
Elżbieta Buczak-Stec ◽  
Hans-Helmut König ◽  
Lukas Feddern ◽  
André Hajek
Keyword(s):  
Systematic Review ◽  
Sexual Orientation ◽  
Long Term Care ◽  
Bibliographic Databases ◽  
Ageing Population ◽  
Older Individuals ◽  
Inclusion Criteria ◽  
Care Needs ◽  
Term Care

Background: With increasing age, the health status of older individuals commonly deteriorates and their care needs greatly increase. Therefore, many individuals are in need for formal or informal long-term care. In order to plan suitable long-term care settings, it is important to know the long-term care preferences of an ageing population (both heterosexuals and sexual minorities). The aim of this study is to systematically review the literature for evidence on preferences regarding long-term care and the potential differences with regard to sexual orientation. Methods and analysis: This study protocol for a systematic review is reported according to the PRISMA-P guidelines. A comprehensive search of published studies will be conducted using PubMed, Web of Science and PsycINFO bibliographic databases. Following predefined inclusion criteria, two authors will screen the titles and abstracts of the studies independently. Afterwards, we will obtain and screen full-text articles of eligible studies using the predefined inclusion criteria. Discrepancies will be resolved by consensus or consultation with a third researcher. Data will be extracted and synthesised. Extracted data will be categorised based on study design, type of long-term care preferences and the group (sexual orientation) which is addressed. The quality of reporting of the studies included will be assessed.

scholarly journals Simulating the Impact of Long-Term Care Prevention Among Older Japanese People on Healthcare Costs From 2020 to 2040 Using System Dynamics Modeling

2020 ◽  
Vol 8 ◽  
Author(s):  
Nobuo Nishi ◽  
Nayu Ikeda ◽  
Takehiro Sugiyama ◽  
Kayo Kurotani ◽  
Motohiko Miyachi
Keyword(s):  
Healthcare Costs ◽  
Long Term Care ◽  
Dynamics Modeling ◽  
Japanese People ◽  
Care Needs ◽  
Term Care ◽  
Death Rates ◽  
Annual Reduction ◽  
The Impact

Objectives: This study examined how healthcare costs might change by reducing long-term care needs among older Japanese people.Methods: A simulation model was constructed comprising two aging chains for independent and dependent people aged ≥65 years by sex. Changes in the base run from 2020 to 2040 were compared with those in two hypothetical scenarios: a 2% annual reduction in death rates (S1), and S1 plus a 2% annual reduction in the proportion of dependent people aged 65 years and in transition rates from the independent to dependent state for people aged ≥65 years (S2).Results: In the base run, the population increased by 13.0% for men and 11.3% for women, and the proportion of dependent people increased by 4.6% for men but decreased by 13.4% for women. The sum of medical and long-term care expenditure increased in the base run, S1, and S2 by 8.2, 27.4, and 16.4%, respectively, for men and women combined.Conclusions: Healthcare costs will increase as death rates fall, but the increase will be attenuated if the proportion of dependent people decreases.

Modelling ageing populations to 2030: financing long-term care in England

2018 ◽  
Author(s):  
Michael Murphy ◽  
Ruth Hancock ◽  
Raphael Wittenberg ◽  
Bo Hu ◽  
Marcello Morciano ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Public And Private ◽  
Care Services ◽  
Private Expenditure ◽  
The Impact ◽  
Care Costs

This chapter presents some findings from the research project ‘Modelling Needs and Resources of Older People to 2030’ (MAP2030). The project developed a set of projection models to estimate future family circumstances, incomes, pensions, savings, disability and care needs of older people in England. These projections included public and private expenditure on pensions, disability benefits and care services under different scenarios for reform of pensions and long-term care funding under a range of alternative population futures. The chapter focuses on the projected future costs and impacts for the different income quintiles of the older population of proposed reforms to the system of funding adult social care, in particular the impact of a cap on individual liability to meet care costs.

scholarly journals Dependent, Poorer, and More Care-Demanding? An Analysis of the Relationship between Being Dependent, Household Income, and Formal and Informal Care Use in Spain

2021 ◽  
Vol 18 (8) ◽  
pp. 4339
Author(s):  
Beatriz Rodríguez-Sánchez ◽  
Marta Pascual Sáez ◽  
David Cantarero-Prieto
Keyword(s):  
Social Services ◽  
Informal Care ◽  
Household Income ◽  
Long Term Care ◽  
Personal Autonomy ◽  
Care Needs ◽  
Demographic Ageing ◽  
Term Care ◽  
The Impact

Population ageing is one of the current challenges that most societies are facing, with great implications for health systems and social services, including long-term care. This increasing long-term care use is particularly rising for dependent older people, motivating the implementation of regional dependency laws to ensure their care needs’ coverage. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from the year 2004 until 2017, the aim of this study is to assess the impact that the Spanish System for Personal Autonomy and Dependency might have on (i) household income, according to different needs for care levels, by running Generalized Linear Models (GLMs); and (ii) formal and informal care use depending on the income-related determinant through the performance of logit random-effects regression models. We show that the different degrees of needs for personal care are associated with a lower household income, being associated with an income reduction from €3300 to nearly €3800, depending on the covariates included, per year for the more severely in-need-for-care older adults. Moreover, our findings point towards a higher use of formal and informal care services by the moderate and severe dependents groups, regardless of the household income group and time period. Bearing in mind the demographic ageing, our results highlight the need for the identification of potentially vulnerable populations and the efficient planification of long-term care systems and social support services.

scholarly journals Aging, Dependence, and Long-Term Care: A Systematic Review of Employment Creation

2021 ◽  
Vol 58 ◽  
pp. 004695802110624
Author(s):  
Roberto Martinez-Lacoba ◽  
Isabel Pardo-Garcia ◽  
Francisco Escribano-Sotos
Keyword(s):  
Systematic Review ◽  
Long Term Care ◽  
Population Aging ◽  
Job Creation ◽  
Developed Countries ◽  
Economic Benefits ◽  
Migrant Labor ◽  
Term Care ◽  
The Impact

Population aging is an economic and social challenge in most countries in the world as it generates higher dependency rates and increased demand for long-term care. Undertaking the care of older dependent adults can result in new opportunities for job creation. There is limited knowledge of the impact of dependent care and long-term care on employment. We examined this impact through a systematic review. Countries with conditional cash benefits show job creation, and countries with unconditional economic benefits reveal the development of a grey care market with high participation of migrant labor. Migrant employment in developed countries affects the development of the labor market in the countries of origin. The employment created to care for dependent persons is generally precarious. In conclusion, global aging will increase long-term care worker demand, but the variations in policies can determine what kind of employment is created.

Sign in / Sign up

Export Citation Format

Share Document