BackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid s... more BackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles.ObjectiveThis study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services.MethodsUsing a case study strategy, we described the PAR team’s (nurses, physicians, developers, and researchers) activities within and across the four phases of the res...
Non-clinical aspects contribute to differences in healthcare practices within each country, which... more Non-clinical aspects contribute to differences in healthcare practices within each country, which may imply that some patients do not receive the care they need. In contrast, others may not benefit from the care that they receive. However, to the authors’ knowledge, only a few geographical variation studies with a national scope were recently conducted in Portugal. This study aimed to test if it was possible to conduct a geographical variation analysis in Portugal using publicly available data to compare the 18 districts and stimulate a debate around this topic. To achieve this goal, we first investigated the publicly available Portuguese National Health Service database (Transparency Portal) for data from activities and procedures that could be included in this analysis. Four were included: percentage of cesarian sections in total births, rate of hip surgeries within the first 48 h after admission in patients older than 65, rate of consumed antibiotics in the total drugs consumed, ...
The goal of this study is to examine the impact of formal home care on the spousal caregiver’sphy... more The goal of this study is to examine the impact of formal home care on the spousal caregiver’sphysical and mental health. From a sample of 6.136 caregivers, who participated in the SHAREsurvey, 23% received formal home care. This project uses different methodologies: OrderedProbit regressions, Propensity Score Matching, and Fixed Effects estimation. The analysisrevealed that formal home care has no impact on caregiver’s physical and mental health, thatmale caregivers are more likely to benefit from it and seem to have a better overall experience.Also, the health status of the care receivers has a positive impact on caregiver’s health
This study estimates the impacts of formal home care provided by paid professionals on spousal he... more This study estimates the impacts of formal home care provided by paid professionals on spousal health outcomes. We use data from the Survey of Health, Ageing, and Retirement in Europe, a panel of older adults living in several European countries, and match new formal home care users to non-users to account for the endogeneity of the decision to seek formal home care. After considering underlying mechanisms, our results suggest that at least in the short run, the use of formal home care does not impact spousal physical or mental health. We also find that formal home care use increases spousal informal caregiving —along the extensive margin—, although in our sample and short time horizon, spousal informal caregiving does not seem to impact health.
Background: Emergency department (ED) High users (HU), defined as having more than ten visits to ... more Background: Emergency department (ED) High users (HU), defined as having more than ten visits to the ED per year, are a small group of patients that use a significant proportion of ED resources. The High Users Resolution Group(GRHU) identifies and provides care toHUto improve their health situation and reduce their visit frequency to the ED by delivering patient-centered, case management integrated care. Objectives: The main objective of this study was to measure the impact in terms of hospital visits of the GRHU intervention. Additionally, we aim to compare the program costs against its potential savings or additional costs. Finally, we intend to study the impact of the intervention across different groups of patients. Methods: We studied The changes triggered by the GRHU program in a retrospective non-controlled before-after analysis of patients’ hospital utilization data on six and 12-month windows from the first appointment. The GRHU team provided the patients’ and cost data. Re...
BackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid s... more BackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles.ObjectiveThis study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services.MethodsUsing a case study strategy, we described the PAR team’s (nurses, physicians, developers, and researchers) activities within and across the four phases of the res...
Non-clinical aspects contribute to differences in healthcare practices within each country, which... more Non-clinical aspects contribute to differences in healthcare practices within each country, which may imply that some patients do not receive the care they need. In contrast, others may not benefit from the care that they receive. However, to the authors’ knowledge, only a few geographical variation studies with a national scope were recently conducted in Portugal. This study aimed to test if it was possible to conduct a geographical variation analysis in Portugal using publicly available data to compare the 18 districts and stimulate a debate around this topic. To achieve this goal, we first investigated the publicly available Portuguese National Health Service database (Transparency Portal) for data from activities and procedures that could be included in this analysis. Four were included: percentage of cesarian sections in total births, rate of hip surgeries within the first 48 h after admission in patients older than 65, rate of consumed antibiotics in the total drugs consumed, ...
The goal of this study is to examine the impact of formal home care on the spousal caregiver’sphy... more The goal of this study is to examine the impact of formal home care on the spousal caregiver’sphysical and mental health. From a sample of 6.136 caregivers, who participated in the SHAREsurvey, 23% received formal home care. This project uses different methodologies: OrderedProbit regressions, Propensity Score Matching, and Fixed Effects estimation. The analysisrevealed that formal home care has no impact on caregiver’s physical and mental health, thatmale caregivers are more likely to benefit from it and seem to have a better overall experience.Also, the health status of the care receivers has a positive impact on caregiver’s health
This study estimates the impacts of formal home care provided by paid professionals on spousal he... more This study estimates the impacts of formal home care provided by paid professionals on spousal health outcomes. We use data from the Survey of Health, Ageing, and Retirement in Europe, a panel of older adults living in several European countries, and match new formal home care users to non-users to account for the endogeneity of the decision to seek formal home care. After considering underlying mechanisms, our results suggest that at least in the short run, the use of formal home care does not impact spousal physical or mental health. We also find that formal home care use increases spousal informal caregiving —along the extensive margin—, although in our sample and short time horizon, spousal informal caregiving does not seem to impact health.
Background: Emergency department (ED) High users (HU), defined as having more than ten visits to ... more Background: Emergency department (ED) High users (HU), defined as having more than ten visits to the ED per year, are a small group of patients that use a significant proportion of ED resources. The High Users Resolution Group(GRHU) identifies and provides care toHUto improve their health situation and reduce their visit frequency to the ED by delivering patient-centered, case management integrated care. Objectives: The main objective of this study was to measure the impact in terms of hospital visits of the GRHU intervention. Additionally, we aim to compare the program costs against its potential savings or additional costs. Finally, we intend to study the impact of the intervention across different groups of patients. Methods: We studied The changes triggered by the GRHU program in a retrospective non-controlled before-after analysis of patients’ hospital utilization data on six and 12-month windows from the first appointment. The GRHU team provided the patients’ and cost data. Re...
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