Effects of an integrated care intervention on frail elderly’s health and quality of life

Introduction: Current care delivery to frail elderly is fragmented; professionals cooperate insufficiently and separately address the complex and diverse needs of frail elderly in the areas of prevention, care, cure, residence and welfare.Integrated care has been promoted as a mean to solve these problems and aims at increasing the effectiveness of care for frail elderly.This study explores the value of an integrated care model for the community-dwelling frail elderly compared to usual care by evaluating the effects on health-related outcomes and quality of life.Intervention: Frailty was preventively detected in elderly living at home with the Groningen Frailty Indicator and geriatric assessment was executed with the EASYcare instrument.Geriatric nurse practitioners and secondary care geriatric nursing specialists were assigned as case managers and coordinated the care agreed upon in a multidisciplinary meeting.The GP practice functions as a single entry point and the GP supervises the coordination of care.The intervention encompasses task reassignment between nurses and doctors and consultations between primary, secondary and tertiary care providers.The entire process was supported by multidisciplinary protocols and web-based patient files. Methods:The design of this study was quasi-experimental.In this study, 184 frail elderly patients of three GP practices that implemented the Walcheren Integrated Care Model were compared with 193 frail elderly patients of five GP practices that provided care as usual.The outcomes were assessed using questionnaires.Baseline measures were compared with a twelve-month follow-up by chi-square tests, t-tests and regression analysis. Results:The Walcheren Integrated Care Model had a positive effect on general quality of life and attachment.Attachment is a dimension of quality of life and refers the capability to obtain love and friendship.No significant differences were found on health-related outcomes such as experienced health, mental health, physical and social functioning

Family medicine · Geriatrics · Health care · Integrated care · Intervention (counseling · Multidisciplinary approach · Psychological intervention · Quality of life (healthcare · Residence · Aging and Gerontology Research · Frailty in Older Adults · Medicine · Nursing · Palliative Care and End-of-Life Issues · Gerontology