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Development of an individualized service plan tool and rules for case management in Qu├ębec.

https://arctichealth.org/en/permalink/ahliterature148406
Source
Care Manag J. 2009;10(3):89-99
Publication Type
Article
Date
2009
Author
Dominique Somme
Lucie Bonin
Paule Lebel
Réjean Hébert
François Blanchard
Author Affiliation
Geriatrics Department, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, France. dominique.somme@egp.aphp.fr
Source
Care Manag J. 2009;10(3):89-99
Date
2009
Language
English
Publication Type
Article
Keywords
Case Management
Delivery of Health Care, Integrated - organization & administration
Humans
Nursing Care
Patient Care Planning - organization & administration
Patient Care Team - organization & administration
Professional Autonomy
Program Development
Quebec
Abstract
From past experience with integrated service delivery, there appears to be a need for a clinical tool to help case managers plan, monitor, and coordinate services. In this context the Québec Ministry of Health and Social Services created a task force to suggest improvements to the Individualized Service Plan tool included in the Multiclientele Assessment Tool. This article reports the findings of this multidisciplinary task force working with various clienteles (older, with physical or mental disabilities, mental diseases). Based on a literature review and recent results from the Program of Research on the Integration of Services for the Maintenance of Autonomy, the task force proposed a dynamic, concise, user-friendly tool and a clear definition of how it should be used. The Individualized Service Plan must list the patient's needs, with an orientation regarding the action plan for each, and a list of services allocated in response to these needs that work in the defined direction. The tool must also contain a section for analyzing variations between the services needed and allocated. This tool was presented to case managers for validation and received an enthusiastic response. It should be implemented in the coming years in the provincial Multiclientele Assessment Tool.
PubMed ID
19772206 View in PubMed
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A system of integrated care for older persons with disabilities in Canada: results from a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature169803
Source
J Gerontol A Biol Sci Med Sci. 2006 Apr;61(4):367-73
Publication Type
Article
Date
Apr-2006
Author
François Béland
Howard Bergman
Paule Lebel
A Mark Clarfield
Pierre Tousignant
André-Pierre Contandriopoulos
Luc Dallaire
Author Affiliation
Solidage Research Group, Montréal, Québec, Canada.
Source
J Gerontol A Biol Sci Med Sci. 2006 Apr;61(4):367-73
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Community Health Services - organization & administration
Delivery of Health Care, Integrated - organization & administration
Disabled Persons
Female
Frail Elderly
Health Expenditures
Health Services - economics - utilization
Humans
Length of Stay
Male
Middle Aged
Patient satisfaction
Social Work - organization & administration
Abstract
Care for elderly persons with disabilities is usually characterized by fragmentation, often leading to more intrusive and expensive forms of care such as hospitalization and institutionalization. There has been increasing interest in the ability of integrated models to improve health, satisfaction, and service utilization outcomes.
A program of integrated care for vulnerable community-dwelling elderly persons (SIPA [French acronym for System of Integrated Care for Older Persons]) was compared to usual care with a randomized control trial. SIPA offered community-based care with local agencies responsible for the full range and coordination of community and institutional (acute and long-term) health and social services. Primary outcomes were utilization and public costs of institutional and community care. Secondary outcomes included health status, satisfaction with care, caregiver burden, and out-of-pocket expenses.
Accessibility was increased for health and social home care with increased intensification of home health care. There was a 50% reduction in hospital alternate level inpatient stays ("bed blockers") but no significant differences in utilization and costs of emergency department, hospital acute inpatient, and nursing home stays. For all study participants, average community costs per person were C dollar 3390 higher in the SIPA group but institutional costs were C dollar 3770 lower with, as hypothesized, no difference in total overall costs per person in the two groups. Satisfaction was increased for SIPA caregivers with no increase in caregiver burden or out-of-pocket costs. As expected, there was no difference in health outcomes.
Integrated systems appear to be feasible and have the potential to reduce hospital and nursing home utilization without increasing costs.
Notes
Comment In: J Gerontol A Biol Sci Med Sci. 2006 May;61(5):472-316720743
PubMed ID
16611703 View in PubMed
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