Demographics and clinical determinants of integrated care usage in social security patients: an Ecuadorian experience/Demografía y determinantes clínicos del uso de la atención …

Abstract:

Methods: A two-step design: descriptive analysis of the service and of attended patients at baseline, and a subsequent longitudinal approach. Firstly, we developed the HV service according to specialized literature. Business Process Modelling Notation diagram was used for describing the processes. We listed processes and compared them with the components of the IC model for ensuring that our service was IC. Briefly, the intervention consisted in assessing and delivering health care to homebound chronic patients who spontaneously requested HV; this was a coordinated process, in which social worker, nurse and family physician were permanently communicated. Patients were attended in their house, with an On-line access to their medical records, with the possibility of transferring, requesting specialist care or simply performing requests for urgent or planned diagnostic and therapeutic procedures. Social and/or health care workers evaluated patients’ house for potential risks (eg falls, fire, etc.). Secondly, a total of 120 homebound patients were assessed at baseline (fist HV), we counted the number of HV for each patient–as a proxy of the usage of the service–at one and a half year of follow up. Demographics and clinical characteristics (medical diagnosis, number of diseases, number of medicines and need for clinical procedures) were measured at baseline. Uni, bi and multivariate analyses were done in order to identify determinants of the HV number. Stratified analyses were proposed for future assessment of the service, by using the resulting categories of service's usage. Results: The service’s components met criteria as IC. Care …

Año de publicación:

2015

Keywords:

Fuente:

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