[Every week counts: Use of health services and related costs of a community-based cohort of people with advanced chronic diseases].
Cada semana cuenta: uso de dispositivos sanitarios y costes relacionados de una cohorte comunitaria de personas con enfermedades crónicas avanzadas.
Atención paliativa
Atención primaria
Community
Comunidad
Mortalidad
Mortality
Palliative care
Primary care
Journal
Atencion primaria
ISSN: 1578-1275
Titre abrégé: Aten Primaria
Pays: Spain
ID NLM: 9111075
Informations de publication
Date de publication:
Historique:
received:
09
01
2018
revised:
01
03
2018
accepted:
13
03
2018
pubmed:
29
9
2018
medline:
21
8
2020
entrez:
29
9
2018
Statut:
ppublish
Résumé
To describe the use of health resources of people with advanced chronicity, quantifying and characterizing its cost to suggest improvements in health care models. Observational, analytical and prospective study during 3 years of a cohort of people with advanced chronicity. Three primary care teams (EAP) of Osona, Cataluña. 224 people identified as advanced patients through a systematic population strategy. Age, sex, type of home, end-of-life trajectory; use, type and cost of resources in primary care, emergencies, palliative teams or hospitalization (in acute or intermediate care). Patients made an average of 1.1 admissions per year (average stay=6 days), 74% in intermediate care hospitals. They lived in the community 93.4% of time, carrying out 1 weekly contact with the EAP (45.1% home care). The average daily cost was 19.4euros, the main chapters were intermediate care hospitalizations (36.5%), EAP activity (29.4%) and admissions in acute hospitals (28.6%). Factors determining a potential lower cost are frailty/dementia as trajectory (p<0.001), living in a nursing-home facility (p<0.001) and over-aging (p<0.001). There are certain differences in the behavior of the EAP related to the global cost and to community resources (p<0.05). Consumption in intermediate hospitalization and primary care is more relevant than stays in acute care centers. Nursing-homes and home-care strategies are important to attend effectively and efficiently, especially when primary care teams get ready for it.
Identifiants
pubmed: 30262222
pii: S0212-6567(18)30009-X
doi: 10.1016/j.aprim.2018.03.008
pmc: PMC6836980
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
spa
Sous-ensembles de citation
IM
Pagination
359-366Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.
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