Community health services in European literature: A systematic review of their features, outcomes, and nursing contribution to care.

Community care services home care services nursing determinants nursing homes patient outcomes primary care remote health systematic review transitional care

Journal

International nursing review
ISSN: 1466-7657
Titre abrégé: Int Nurs Rev
Pays: England
ID NLM: 7808754

Informations de publication

Date de publication:
29 Jul 2024
Historique:
received: 21 12 2023
accepted: 12 07 2024
medline: 29 7 2024
pubmed: 29 7 2024
entrez: 29 7 2024
Statut: aheadofprint

Résumé

To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored. Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing-related determinants of outcomes. A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856). Twenty-three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services' effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long-term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated. Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models. Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.

Sections du résumé

BACKGROUND BACKGROUND
To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored.
INTRODUCTION BACKGROUND
Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing-related determinants of outcomes.
METHODS METHODS
A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856).
RESULTS RESULTS
Twenty-three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services' effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long-term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated.
DISCUSSION CONCLUSIONS
Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models.
CONCLUSIONS AND IMPLICATIONS FOR HEALTH POLICY UNASSIGNED
Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.

Identifiants

pubmed: 39073363
doi: 10.1111/inr.13033
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

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Auteurs

Valeria Caponnetto (V)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Angelo Dante (A)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Khadija El Aoufy (K)

Department of Health Sciences, University of Florence, Florence, Italy.

Maria Ramona Melis (MR)

Staff Training Department, Careggi University Hospital, Florence, Italy.

Giulia Ottonello (G)

Department of Health Sciences, University of Genoa, Genova, Italy.
Ingram School of Nursing, McGill University, Montreal, Canada.
Direction of Health Professionals, "IRCCS Istituto Giannina Gaslini,", Genova, Italy.

Francesca Napolitano (F)

Department of Health Sciences, University of Genoa, Genova, Italy.
Department of Emergency and Admission, Policlinic Hospital "IRCSS San Martino,", Genova, Italy.

Fabio Ferraiuolo (F)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Francesco Camero (F)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Angela Cuoco (A)

Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Orthopedic and Traumatology Clinic, Orthopedic Institute "IRCSS Rizzoli,", Bologna, Italy.

Ilaria Erba (I)

Bachelor of Science in Nursing, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.

Laura Rasero (L)

Department of Health Sciences, University of Florence, Florence, Italy.
Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.

Loredana Sasso (L)

Department of Health Sciences, University of Genoa, Genova, Italy.
Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.

Annamaria Bagnasco (A)

Department of Health Sciences, University of Genoa, Genova, Italy.
Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.

Rosaria Alvaro (R)

Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.

Duilio Fiorenzo Manara (DF)

Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.
Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy.

Gennaro Rocco (G)

Center of Excellence for Nursing Scholarship, Rome, Italy.
Faculty of Medicine, University "Our Lady of the Good Counsel", Tirana, Albania.

Maurizio Zega (M)

Center of Excellence for Nursing Scholarship, Rome, Italy.
FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.

Giancarlo Cicolini (G)

FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.
Section of Nursing and Midwifery, Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti - Pescara, Chieti, Italy.

Beatrice Mazzoleni (B)

FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Loreto Lancia (L)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy.

Classifications MeSH