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- Barbabella, Francesco, Dr. 1984-, et al.
(författare)
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Ecological factors associated with Emergency Department use by older people in Italy.
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33, s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many studies investigated factors associated with overuse of Emergency Department (ED) by older people. However, there is little evidence of how a better access to long-term care services can affect ED visit rates. Therefore, we estimated the association between ED use and contextual (distance to closest ED), need (priority level at admission and care deprivation), predisposing (socio-economic conditions) and enabling factors (availability of health services) at the municipal level.METHODS: We investigated ED visit rates by comparing the older population (aged 75 and more) to those aged less than 75 years among 233 municipalities and 13 health districts in the Marche Region, Central Italy. Administrative data were enriched by spatial dimensions. The outcomes were analysed using t-tests and ANOVA, while OLS and multilevel regressions have been used to identify independent correlates of ED visit rates.RESULTS: Mean ED visit rate was 56.3% and 25.3% among older people and the rest of the population (< 75 years), respectively. The multivariate analysis for older people showed that the presence of an ED within the municipality and living alone were positively associated with ED use, whereas greater availability of nursing homes was negatively associated. For general population (< 75 years), distance to closest ED, economic deprivation and bigger hospitals were negatively associated with ED visits.CONCLUSIONS: Our study shows that interventions to reduce frequent ED use by older people should include the availability of long-term care facilities in the area. As population ageing is progressing, our results suggest that investing in alternative care options for older people with long-term care needs might have the beneficial impact of reducing the overall ED rates and improving quality and appropriateness of care.
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- Gori, Cristiano, et al.
(författare)
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How different countries allocate long-term care resources to older users : changes over time
- 2016
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Ingår i: Long-term care reforms in OECD countries. - Bristol : Policy Press. - 978 144731 071 6 ; , s. 77-116
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Bokkapitel (refereegranskat)abstract
- A key policy debate in long-term care (LTC) policies across OECD countriestoday can be summarised by the following question: what measures and strategiescan be adopted to optimise resources? New policies are required for balancingfinances and access to care, with different options on the table and waiting forgovernments’ decisions.This chapter looks at changes over time in public resource allocation amongLTC users in the same OECD countries considered in the previous chapter (exceptfor Australia). As in Chapter Four, this chapter focuses exclusively on publiccare inputs, defined as those inputs that are (at least partially) publicly funded,and looks at users aged 65 and over. Chapter Four led the way to reconsideringhow public resources are allocated in different LTC systems through an in-depthanalysis of current spending. To complement that analysis, this chapter adopts along-term perspective, investigating the changes that have occurred over the last20–25 years in three crucial dimensions of resource allocation: the mix of LTCservices for older people, their intensity, and their coverage.The countries considered are representative of the OECD environment withrespect to both the overall welfare models and the models of LTC policies.Concerning the former, as Campbell et al have noted in Chapter Four, ‘wehave Sweden in social-democratic Northern Europe, Italy in familial SouthernEurope, Germany in corporatist mid-continent, Australia, the US and Englandas quite different versions of the Anglo-Saxon “residual” model, and Japan as therelatively new entry that shares aspects of all the other models.’ From the pointof view of LTC policies, the sample of countries selected represents the differentmodels in the OECD context:• Universal coverage within a single programme: this model guarantees people access toformal services without taking into account users’ income or assets as eligibilitycriteria. It is also organised as a single system, separated or integrated with theoverall health system (Germany, Japan and Sweden).• Mixed systems: in this case, LTC is provided through a mix of different universalprogrammes and benefits operating alongside, or a mix of universal and meanstestedLTC entitlements (England and Italy).• Means-tested systems: under this type of scheme, LTC coverage is providedthrough safety-net programmes. In countries using this system, income and/or asset tests are used to define thresholds for eligibility to publicly fundedcare. Only those falling below a set threshold are entitled to publicly fundedservices or benefits (the US) (Colombo et al, 2011).This chapter is organised as follows. First, it addresses the issue of resourceallocation, providing a definition of the topic and the methodology used. Themain policies implemented in each of the six countries are then examined. Finally,a comparative discussion on the trends emerging across our sample is presented,followed by a final paragraph looking ahead.
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| 8. |
- Andréasson, Frida, et al.
(författare)
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The INNOVAGE-Eurocarers platform and current ICT-based services for informal carers of older people in Sweden
- 2015
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Ingår i: Irish Ageing Studies Review. - 1649-9972. ; 6:1, s. 88-88
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Tidskriftsartikel (refereegranskat)abstract
- Background: Different support services for family carers are available in Sweden through information and communication technologies (ICTs) since late 1990s, like ACTION, My Joice, IPPI, ‘The Gap’, and Carer Sweden’s online ‘Carer’s Book’. The INNOVAGE-Eurocarers platform aimed to complement the offer of web services to carers through the provision of a new tailored package.Methods: The Swedish pilot test enrolled around 50 carers through contacts with professionals working with carers in different municipalities. They could access the following web-based services: information resources; individual support via e-mail and private messages; group support via social network and forum. Periodical writing activities were asked to active users in the forum, alternating expressive writing (EW) and time management (TM) writing tasks. Periodical reminders were sent in order to increase user involvement.Results: Users were predominantly older, female carers, of which two thirds were over 65 years old. The web platform was perceived as a flexible tool, potentially accessible at any time, which gave users the possibility to exploit their experience as carers with others in similar situations. This peer exchange seemed to improve self empowerment, sense of solidarity and mutual learning. However, usage of the web platform was limited due to the low level of digital skills of some carers.Conclusions: Although results confirmed usefulness and appropriateness of implemented web services, it is fundamental to address the issue of usability and accessibility in order to ensure a wider accessibility. An option might be to offer initial digital skill training and continuous technical support for computer novices.
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- Andréasson, Frida, et al.
(författare)
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The use of on-line social network and services by family carers with high digital skills : The case of the Swedish sample
- 2016
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Konferensbidrag (refereegranskat)abstract
- AIMS. The InformCare platform aimed to complement the offer of already available web services to carers through the provision of a new comprehensive package.METHODS. 36 family carers were enrolled in Sweden and used the platform during the intervention. They could access the following web-based services: information resources; individual support via e-mail and private messages; group support via social network and forum. Periodical writing activities were asked to active users in the forum, alternating expressive writing (EW) and time management (TM) writing tasks.FINDINGS. Users were predominantly older, female carers, who considered the web platform as a flexible tool, potentially accessible at anytime, which could empower users and improve their sense of solidarity and mutual learning.CONCLUSIONS. Although results confirmed usefulness and appropriateness of implemented web services, some carers experienced problems in accessing and navigation, which required continuous technical support by web developers.
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- Barbabella, Francesco, 1984-, et al.
(författare)
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A multilingual web platform supporting informal carers in 27 EU member states
- 2015
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Ingår i: Broader, bigger, better: AAL solutions for Europe. Proceedings of the 6<sup>th</sup> AAL Forum 2014. - Bucharest : UEFISCDI. - 9789730201192 ; , s. 169-172
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Konferensbidrag (refereegranskat)abstract
- Informal care is a hot topic in research and policy agendas at European and national level, since it greatly contributes to the sustainability and efficiency of national health care systems. A specific intervention – part of the wider INNOVAGE project funded by FP7 – was planned for developing and testing a new multilingual web platform for informal carers of dependent older people in the EU-27. Preliminary results of the pilot study, conducted in Italy, Germany and Sweden will be discussed. The final platform will be accessible in all official languages of the EU-27 and publicly available in spring 2015.
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