| 1. |
- 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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| 4. |
- 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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| 5. |
- 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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| 6. |
- 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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| 7. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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A theoretical framework for assessing the impact of ICT-based interventions for carers
- 2012
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Ingår i: Gerontechnology. - 1569-1101 .- 1569-111X. ; 11:2, s. 393-393
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Initiatives using information and communication technologies (ICTs) as support for carers of dependent older people are reported since the early 1990s, mainly in form of phone services, computer networks, and video respite. Although the role of ICTs in home care gained increasing relevance in the last decades – for instance in the areas of social integration, care coordination and ambient assisted living (AAL) – few attempts have been made to systematically understand the potentialities of such technologies, overcoming single technology or intervention domains. In this respect, the issues of terminology ambiguity and lack of comparability represented major barriers, so that most of evaluation studies in this area led to mixed and/or inconclusive results. Drawing on the findings of the CARICT-project, this paper discusses the development of a theoretical and conceptual framework to assess the impact ofI CT-based interventions for carers. Method Literature review and a mapping exercise of 52 ICT-based initiatives for carers in 8 countries. Results & Discussion We will provide the results of a mapping exercise of 52 case studies, showing the diversity of existing good practices across Europe and carrying out a review of available impact assessment of these initiatives from a social ecological perspective (at micro-, meso- and macro-level). Subsewquently, we will discuss a theoretical and conceptual framework that is built on the basis of available evidence, leading toa proper classification of ICT-based interventions in relation to types of interactions between actors they support: an attempt is made to group the solutions in coherent and comprehensive classes, with related implications for impact assessments and comparative analysis. Main classes include: alarms, home automation, auto-communication, meta-services, information and training, cognitive stimulations and mental exercises, support group sessions, individual care and support services, and social participation tools. Finally, recommendations for future research in the field are formulated with regard to the assessment and comparability of these services, as well as to the testing and development of new solutions.
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| 8. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Alcuni profili dell’assistenza nelle regioni
- 2013
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Ingår i: L'assistenza agli anziani non autosufficienti in Italia. - Rimini : Maggioli Editore. - 8838735646 ; , s. 29-43
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Bokkapitel (refereegranskat)
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| 9. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Assessing the Impact of ICT-based Solutions for Carers in Europe : Preliminary Findings from the CARICT Project
- 2012
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Ingår i: Conference “Challenge Social Innovation: Innovating innovation by research – 100 years after Schumpeter”. - : ZSI.
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Konferensbidrag (refereegranskat)abstract
- Some evidence suggests that information and communication technologies (ICT) can be an efficient mean to improve not only the quality of care provided to dependent older people but also the support for informal carers and privately employed care workers. However, there is a lack of research on ICT-based initiatives and their impact on carers in the European context. Moving from the preliminary findings of the CARICTproject, the paper discusses the first attempt that has been made in Europe to assess the impact of ICTbased initiatives for carers. First, an overview of the developed methodological framework is presented: it includes both a conceptual framework and an impact assessment methodology (IAM) for evaluating multidimensional outcome. Furthermore, an overview of ICT-based solutions in Europe is provided through the analysis of 52 operational initiatives and selected as good practices. Finally, some recommendations and guidelines for further research in the field are discussed.
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| 10. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Caring For People With Multiple Chronic Conditions In Italy : Policy And Practices
- 2015
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Ingår i: Irish Ageing Studies Review. - 1649-9972. ; 6:1, s. 71-71
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Tidskriftsartikel (refereegranskat)abstract
- Background: An estimated 50 million people in the European Union live with multiple chronic diseases. In Italy, around 26.6% of the population aged 16 to 64 years, reported to have at least one long-standing illness or health problem in 2011. Moreover, around 46% of the population over 50 is suffering from multimorbidity. Some programmes addressing adult or older people with multimorbidity have been introduced.Methods: Data for the ICARE4EU study were collected in the first half of 2014. Eligible programmes focussed on providing care for adult people with two or more medically diagnosed chronic or long lasting diseases (at least onesomatic), involved formalised cooperation between two or more services (at least one medical) and evaluation was available. For each programme an on-line questionnaire was completed and included four main subjects: Patientcentredness, Management, Use of E-health technologies, and Financing systems.Results: In Italy, four programmes met the inclusion criteria. They address both daily patient care and policy/managerial levels. Integration of care services, improved collaboration between care providers, changes in resource utilisation and involvement of informal carers have been observed. In two programmes, older patients are addressed as specific subgroup and in two cases animprovement in the use of E-health tools has emerged.Conclusions: In Italy, new policies and integrated care programmes addressing multimorbidity have been recently introduced in some areas, with good preliminary results.
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