Abstract:
BACKGROUND:Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia. METHODS:A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, Scopus and PubMed were searched from 1994 to May 2009. Two researchers independently reviewed search results. RESULTS:Thirty five papers were included in this review. Evidence from randomized controlled trials showed that case management improves function and appropriate use of medications, increases use of community services and reduces nursing home admission. Evidence, mostly from non-randomized trials, showed that integrated care increases service use; randomized trials reported that integrated care does not improve clinical outcomes. The lowest quality evidence was for consumer directed care which appears to increase satisfaction with care and community service use but has little effect on clinical outcomes. Studies were heterogeneous in methodology and results were not consistent. CONCLUSIONS:The outcomes of each model of care differ and correspond to the model's focus. Combining key elements of all three models may maximize outcomes.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Low LF,Yap M,Brodaty Hdoi
10.1186/1472-6963-11-93subject
Has Abstractpub_date
2011-05-09 00:00:00pages
93issn
1472-6963pii
1472-6963-11-93journal_volume
11pub_type
杂志文章,评审abstract:BACKGROUND:Pathologists face major challenges in breast cancer diagnostics in sub-Saharan Africa (SSA). The major problems identified as impairing the quality of pathology reports are shortcomings of equipment, organization and insufficiently qualified personnel. In addition, in the context of breast cancer, immunohist...
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