Evaluating Person-Centred Integrated Care to People with Complex Chronic Conditions: Early Implementation Results of the ProPCC Programme.

IF 2.6 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES International Journal of Integrated Care Pub Date : 2023-12-13 eCollection Date: 2023-10-01 DOI:10.5334/ijic.7585
Miquel À Mas, Ramón Miralles, Maria J Ulldemolins, Ria Garcia, Sonia Gràcia, Josep M Picaza, Mercedes Navarro Fernández, Maria A Rocabayera, Montserrat Rivera, Núria Relaño, Mireia Torres Asensio, Pilar Laporta, Celia Morcillo, Laura Nadal, Ramona Hervás, Dolors Fuguet, Cristina Alba, Núria Miralles Banqué, Sònia Jimenez, Miriam Moreno Moreno, Carmen Nogueras, Helena Manjón Navarro, Rosa López, Guillem Hernández, Francesc López-Seguí, Laura Ricou Ríos, Arnau Pons, Nuria Prat, Jordi Ara Del Rey, Oriol Estrada
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Abstract

Introduction: The evaluation of integrated care programmes for high-need high-cost older people is a challenge. We aim to share the early implementation results of the ProPCC programme in the North-Barcelona metropolitan area, in Catalonia, Spain.

Methods: We analysed the intervention with retrospective data from May 2018 to December 2021 by describing the cohort complexity and by showing its 6-months pre-post impact on time spent at home and resources used: primary care visits, emergency department visits, hospital admissions and hospital stay.

Findings: 264 cases were included (91% at home; 9% in nursing homes). 6-month pre vs. 6-months post results were (mean, p-value): primary care visits 8.2 vs. 11.5 (p < 0.05); emergency department visits 1.4 vs. 0.9 (p < 0.05); hospital admissions 0.7 vs. 0.5 (p < 0.05); hospital stay 12.8 vs. 7.9 days (p < 0.05). Time spent at home was 169.2 vs.174.2 days (p < 0.05).

Conclusion: Early implementation of the ProPCC programme results in an increase in time spent at home (up to 3%) and significant reductions in emergency department attendance (-37.2%) and hospital stays (-38.3%). The increased use of primary care resources is compensated by the hospital resources savings, with a result in the average total cost of -46.3%.

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评估以人为本的慢性病患者综合护理:ProPCC 计划的早期实施结果。
导言:对高需求、高成本老年人的综合护理计划进行评估是一项挑战。我们旨在分享 ProPCC 计划在西班牙加泰罗尼亚北巴塞罗那大都市区的早期实施成果:我们利用 2018 年 5 月至 2021 年 12 月的回顾性数据分析了干预措施,描述了队列的复杂性,并显示了干预措施实施 6 个月后对居家时间和所用资源(初级保健就诊、急诊就诊、入院和住院)的影响。结果:共纳入 264 个病例(91% 居家;9% 住在养老院)。治疗前 6 个月与治疗后 6 个月的结果(平均值,P 值)分别为:初级保健就诊 8.2 次与 11.5 次(P < 0.05);急诊就诊 1.4 次与 0.9 次(P < 0.05);入院 0.7 次与 0.5 次(P < 0.05);住院 12.8 天与 7.9 天(P < 0.05)。在家中度过的时间为 169.2 对 174.2 天(P < 0.05):及早实施 ProPCC 计划可增加居家时间(最多 3%),并显著减少急诊就诊率(-37.2%)和住院时间(-38.3%)。医院资源的节省弥补了初级保健资源使用的增加,使平均总成本降低了 46.3%。
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来源期刊
International Journal of Integrated Care
International Journal of Integrated Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.80
自引率
8.30%
发文量
887
审稿时长
>12 weeks
期刊介绍: Established in 2000, IJIC’s mission is to promote integrated care as a scientific discipline. IJIC’s primary purpose is to examine critically the policy and practice of integrated care and whether and how this has impacted on quality-of-care, user experiences, and cost-effectiveness. The journal regularly publishes conference supplements and special themed editions. To find out more contact Managing Editor, Susan Royer. The Journal is supported by the International Foundation for Integrated Care (IFIC).
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