The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study
Abstract Background To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed and implemented in The Netherlands. The purpose of this study was to assess the effects of this pathway on patients and informal caregivers. Methods Two cohorts of...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-018-0971-4 |
| _version_ | 1819228754481774592 |
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| author | Irma H. J. Everink Jolanda C. M. van Haastregt Frans E. S. Tan Jos M. G. A. Schols Gertrudis I. J. M. Kempen |
| author_facet | Irma H. J. Everink Jolanda C. M. van Haastregt Frans E. S. Tan Jos M. G. A. Schols Gertrudis I. J. M. Kempen |
| author_sort | Irma H. J. Everink |
| collection | DOAJ |
| description | Abstract Background To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed and implemented in The Netherlands. The purpose of this study was to assess the effects of this pathway on patients and informal caregivers. Methods Two cohorts of patients and their informal caregivers were prospectively recruited before implementation of the pathway (2011–2012) and after implementation of the pathway (2013–2014). Primary outcome measures were dependence in activities of daily living in patients (KATZ-15) and self-rated burden among informal caregivers (SRB-VAS). Secondary outcome measures were the frequency of performing extended daily activities, social participation, psychological well-being, quality of life and discharge location (patients) and quality of life and objective care burden (informal caregivers). Outcomes were measured at baseline, after three and after nine months. Results No effect was shown on the KATZ-15 after three and nine months. However, a larger percentage of patients were discharged home in the care pathway cohort (83% vs 58.1% after three months and 88.6% vs 67.4% after nine months; p = 0.004). Furthermore, after three months, patients from the care pathway cohort performed more extended daily activities (p = 0.014) and informal caregivers experienced a lower self-rated burden (p = 0.05). After nine months, these effects disappeared. No differences were found for the other outcome measures. Conclusions Due to the positive effects of the integrated care pathway, we are inclined to recommend implementing the care pathway in regular care. To have longer lasting effects among patients and informal caregivers, we suggest actively disseminating information about the pathway to primary care providers who are currently still unaware of its content. Trial registration ISRCTN90000867 (date of registration: 07-04-2016). |
| first_indexed | 2024-12-23T11:02:18Z |
| format | Article |
| id | doaj.art-f3d61ea91da3464f86ba6aea066007e3 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-23T11:02:18Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-f3d61ea91da3464f86ba6aea066007e32022-12-21T17:49:35ZengBMCBMC Geriatrics1471-23182018-11-0118111310.1186/s12877-018-0971-4The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort studyIrma H. J. Everink0Jolanda C. M. van Haastregt1Frans E. S. Tan2Jos M. G. A. Schols3Gertrudis I. J. M. Kempen4Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht UniversityDepartment of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht UniversityDepartment of Methodology and Statistics and Care and Public Health Research Institute (CAPHRI), Maastricht UniversityDepartment of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht UniversityDepartment of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht UniversityAbstract Background To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed and implemented in The Netherlands. The purpose of this study was to assess the effects of this pathway on patients and informal caregivers. Methods Two cohorts of patients and their informal caregivers were prospectively recruited before implementation of the pathway (2011–2012) and after implementation of the pathway (2013–2014). Primary outcome measures were dependence in activities of daily living in patients (KATZ-15) and self-rated burden among informal caregivers (SRB-VAS). Secondary outcome measures were the frequency of performing extended daily activities, social participation, psychological well-being, quality of life and discharge location (patients) and quality of life and objective care burden (informal caregivers). Outcomes were measured at baseline, after three and after nine months. Results No effect was shown on the KATZ-15 after three and nine months. However, a larger percentage of patients were discharged home in the care pathway cohort (83% vs 58.1% after three months and 88.6% vs 67.4% after nine months; p = 0.004). Furthermore, after three months, patients from the care pathway cohort performed more extended daily activities (p = 0.014) and informal caregivers experienced a lower self-rated burden (p = 0.05). After nine months, these effects disappeared. No differences were found for the other outcome measures. Conclusions Due to the positive effects of the integrated care pathway, we are inclined to recommend implementing the care pathway in regular care. To have longer lasting effects among patients and informal caregivers, we suggest actively disseminating information about the pathway to primary care providers who are currently still unaware of its content. Trial registration ISRCTN90000867 (date of registration: 07-04-2016).http://link.springer.com/article/10.1186/s12877-018-0971-4AgedGeriatric rehabilitationSubacute careIntegrated carePathwayDependence in activities of daily living |
| spellingShingle | Irma H. J. Everink Jolanda C. M. van Haastregt Frans E. S. Tan Jos M. G. A. Schols Gertrudis I. J. M. Kempen The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study BMC Geriatrics Aged Geriatric rehabilitation Subacute care Integrated care Pathway Dependence in activities of daily living |
| title | The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study |
| title_full | The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study |
| title_fullStr | The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study |
| title_full_unstemmed | The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study |
| title_short | The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study |
| title_sort | effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers a prospective cohort study |
| topic | Aged Geriatric rehabilitation Subacute care Integrated care Pathway Dependence in activities of daily living |
| url | http://link.springer.com/article/10.1186/s12877-018-0971-4 |
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