Duygu Sezgin1, Rónán O'Caoimh2, Mark R O'Donovan3, Mohamed A Salem4, Siobhán Kennelly5, Luz Lopez Samaniego6, Cristina Arnal Carda7, Rafael Rodriguez-Acuña6, Marco Inzitari8, Teija Hammar9, Claire Holditch10, Janet Prvu Bettger11, Martin Vernon12,13, Áine Carroll14,15, Felix Gradinger16,17, Gaston Perman18, Martin Wilson19, Antoine Vella20, Antonio Cherubini21, Helen Tucker22, Maria Pia Fantini23, Graziano Onder24, Regina Roller-Wirnsberger25, Luis Miguel Gutiérrez-Robledo26, Matteo Cesari27, Paula Bertoluci28, Magdalena Kieliszek29, Wilma van der Vlegel-Brouwer30, Michelle Nelson31,32, Leocadio Rodríguez Mañas33, Eleftheria Antoniadou34, François Barriere35, Sebastian Lindblom36, Grace Park37, Isidoro Pérez38, Dolores Alguacil39, Douglas Lowdon40, Maria Eugenia Alkiza41, Cristina Alonso Bouzon42, John Young43, Ana Carriazo38, Aaron Liew44,45, Anne Hendry46,47. 1. College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway City, Ireland. 2. Department of Geriatric Medicine, Mercy University Hospital Cork, Cork City, Ireland. rocaoimh@hotmail.com. 3. Clinical Sciences Institute, National University of Ireland Galway, Galway City, Ireland. 4. St Vincent De Paule LTC Facility, Marsa, Malta. 5. Older Person's Programme, Health Service Executive, Dublin, Ireland. 6. Andalusian Public Foundation of Progress and Health (FPS), Seville, Spain. 7. Hospital a Domicili Integral Geriatria (HaDo), Barcelona, Spain. 8. Parc Sanitari Pere Virgili, Vall D'Hebrón Institute of Research (VHIR), and Universitat Autònoma de Barcelona, Barcelona, Spain. 9. Finnish Institute for Health and Welfare (THL), Helsinki, Finland. 10. NHS Benchmarking Network, Manchester, England. 11. Duke University, Durham, USA. 12. NHS England, London, England. 13. Manchester University NHS Foundation Trust, London, England. 14. University College Dublin, Dublin, Ireland. 15. National Rehabilitation Hospital, Dún Laoghaire, County Dublin, Ireland. 16. University of Plymouth, Plymouth, England. 17. Torbay and South Devon NHS Foundation Trust, Torbay, England. 18. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 19. Raigmore Hospital Inverness NHS Highland, Inverness, Scotland. 20. Department of Geriatric Medicine, University of Malta, Msida, Malta. 21. Geriatria, Accettazione geriatrica e Centro di Ricerca Per L'invecchiamento, IRCCS INRCA, Ancona, Italy. 22. Community Hospitals Association (UK), University of Winchester, Winchester, England. 23. Post-Graduate Medical School in Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy. 24. Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy. 25. Department of Internal Medicine, Medical University of Graz, Graz, Austria. 26. National Institute of Geriatric Medicine at the National Institutes of Health, Mexico City, Mexico. 27. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università Degli Studi di Milano, Milan, Italy. 28. Alves Pereira, Public Health School, University of São Paulo (FSP/USP), São Paulo, Brazil. 29. Center for Innovation and Technology Transfer, Medical University of Lodz, Lodz, Poland. 30. HU University of Applied Sciences, Utrecht, The Netherlands. 31. Lunenfeld-Tanenbaum Research Institute, Toronto, Canada. 32. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. 33. Jefe de Servicio de Geriatría Hospital Universitario de Getafe, Getafe, Spain. 34. Rehabilitation Clinic Patras University Hospital, Patras, Greece. 35. Pilote MAIA 13 Projets Parcours Pays Salonais, Pays Salonais, France. 36. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. 37. Fraser Health Authority, British Columbia, Canada. 38. Regional Ministry of Health and Families of Andalusia (CSFJA), Seville, Spain. 39. Andalusian Health Service (Servicio Andaluz de Salud, SAS), Seville, Spain. 40. NHS Scotland, Edinburgh, Scotland. 41. Bidasoa Integrated Healthcare Organisation, Osakidetza, Basque Country, Spain. 42. The Spanish Society of Geriatrics Medicine (SEMEG), Madrid, Spain. 43. University of Leeds, Leeds, England. 44. Clinical Sciences Institute, National University of Ireland Galway, Galway, Ireland. 45. Department of Endocrinology, Portiuncula University Hospital, Ballinasloe, Co Galway, Ireland. 46. NHS Lanarkshire, Glasgow, Scotland. 47. University of the West of Scotland, Glasgow, Scotland.
Abstract
BACKGROUND: Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. AIM: To identify and define the characteristics of intermediate care models. METHODS: A scoping review, a modified two-round electronic Delphi study involving 27 multi-professional experts from 13 countries, and a virtual consensus meeting were conducted. RESULTS: Sixty-six records were included in the scoping review, which identified four main themes: transitions, components, benefits and interchangeability. These formed the basis of the first round of the Delphi survey. After Round 2, 16 statements were agreed, refined and collapsed further. Consensus was established for 10 statements addressing the definitions, purpose, target populations, approach to care and organisation of intermediate care models. DISCUSSION: There was agreement that intermediate care represents time-limited services which ensure continuity and quality of care, promote recovery, restore independence and confidence at the interface between home and acute services, with transitional care representing a subset of intermediate care. Models are best delivered by an interdisciplinary team within an integrated health and social care system where a single contact point optimises service access, communication and coordination. CONCLUSIONS: This study identified key defining features of intermediate care to improve understanding and to support comparisons between models and studies evaluating them. More research is required to develop operational definitions for use in different healthcare systems.
BACKGROUND: Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. AIM: To identify and define the characteristics of intermediate care models. METHODS: A scoping review, a modified two-round electronic Delphi study involving 27 multi-professional experts from 13 countries, and a virtual consensus meeting were conducted. RESULTS: Sixty-six records were included in the scoping review, which identified four main themes: transitions, components, benefits and interchangeability. These formed the basis of the first round of the Delphi survey. After Round 2, 16 statements were agreed, refined and collapsed further. Consensus was established for 10 statements addressing the definitions, purpose, target populations, approach to care and organisation of intermediate care models. DISCUSSION: There was agreement that intermediate care represents time-limited services which ensure continuity and quality of care, promote recovery, restore independence and confidence at the interface between home and acute services, with transitional care representing a subset of intermediate care. Models are best delivered by an interdisciplinary team within an integrated health and social care system where a single contact point optimises service access, communication and coordination. CONCLUSIONS: This study identified key defining features of intermediate care to improve understanding and to support comparisons between models and studies evaluating them. More research is required to develop operational definitions for use in different healthcare systems.
Keywords:
Care models; Definition; Delphi technique; Integrated care; Intermediate care; Older adults; Transitional care
Authors: Kadjo Yves Cedric Adja; Jacopo Lenzi; Duygu Sezgin; Rónán O'Caoimh; Mara Morini; Gianfranco Damiani; Alessandra Buja; Maria Pia Fantini Journal: Front Public Health Date: 2020-11-12
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Authors: Elizabeth Moloney; Duygu Sezgin; Mark O'Donovan; Kadjo Yves Cedric Adja; Keith McGrath; Aaron Liew; Jacopo Lenzi; Davide Gori; Kieran O'Connor; David William Molloy; Evelyn Flanagan; Darren McLoughlin; Maria Pia Fantini; Suzanne Timmons; Rónán O'Caoimh Journal: Int J Environ Res Public Health Date: 2022-01-26 Impact factor: 3.390
Authors: Duygu Sezgin; Rónán O'Caoimh; Aaron Liew; Mark R O'Donovan; Maddelena Illario; Mohamed A Salem; Siobhán Kennelly; Ana María Carriazo; Luz Lopez-Samaniego; Cristina Arnal Carda; Rafael Rodriguez-Acuña; Marco Inzitari; Teija Hammar; Anne Hendry Journal: Eur Geriatr Med Date: 2020-08-04 Impact factor: 1.710