What Makes Effective Acute Geriatric Care? - A mixed Methods Study From Aotearoa New Zealand.
Objectives: Current policies for older patients do not adequately address the barriers to effective implementation of optimal care models in New Zealand, partly due to differences in patient definitions and the in-patient pathway they should follow through hospital. This research aims to: (a) synthe...
| Published in: | Ageing International Vol. 49; no. 3; pp. 660 - 684 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
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Springer Nature
Sep2024
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=179605735&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 179605735 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01635158 DUS jtl: Ageing International issn: 01635158 maglogo: N pubinfo: dt: Sep2024 vid: 49 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 179605735 177941750 179605735 179605735 10.1007/s12126-024-09568-7 179605735 ppf: 660 ppct: 24 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: What Makes Effective Acute Geriatric Care? - A mixed Methods Study From Aotearoa New Zealand. aug: au: Ijadi Maghsoodi, Abtin Barlow-Armstrong, Jewel Pavlov, Valery Rouse, Paul Walker, Cameron Graham Parsons, Matthew affil: https://ror.org/03b94tp07 Department of Information Systems and Operations Management, Faculty of Business and Economics, University of Auckland, Auckland, New Zealand sug: subj: Gerontologic Care Acute Care Tertiary Health Care New Zealand Patient Care Health Services for Older Persons Human Male Female New Zealand Multimethod Studies Comorbidity Multidisciplinary Care Team Semi-Structured Interview Thematic Analysis Univariate Statistics Aged Aged, 80 and Over Emergency Service Hospital Units Activities of Daily Living Chronic Disease Iatrogenic Disease Functional Status Length of Stay Readmission Patient Centered Care Discharge Planning Mortality Public Health Stakeholder Participation Outcomes (Health Care) Descriptive Statistics Aged: 65+ years Aged, 80 & over Male Female ab: Objectives: Current policies for older patients do not adequately address the barriers to effective implementation of optimal care models in New Zealand, partly due to differences in patient definitions and the in-patient pathway they should follow through hospital. This research aims to: (a) synthesise a definition of a complex older patient; (b) identify and explore primary and secondary health measures; and (c) identify the primary components of a care model suitable for a tertiary hospital in the midland region of the North Island of New Zealand. Method: This mixed-methods study utilised a convergence model, in which qualitative and quantitative data were investigated separately and then combined for interpretation. Semi-structured interviews (n=11) were analysed using a general inductive method of enquiry to develop key codes, categories and themes. Univariate data analysis was employed using six years of routinely collected data of patients admitted to the emergency department and inpatient units (n=261,773) of the tertiary hospital. Results: A definition of a complex older patient was determined that incorporates chronic conditions, comorbidities and iatrogenic complications, functional decline, activities of daily living, case fatality, mortality, hospital length of stay, hospital costs, discharge destination, hospital readmission and emergency department revisit and age – not necessarily over 65 years old. Well-performing geriatric care models were found to include patient-centred care, frequent medical review, early rehabilitation, early discharge planning, a prepared environment and multidisciplinary teams. Conclusions: The findings of this New Zealand study increase understanding of acute geriatric care for complex older patients by filling a gap in policies and strategies, identifying potential components of an optimal care model and defining a complex geriatric patient. Implications for Public Health: The findings of this study present actionable opportunities for clinicians, managers, academics and policymakers to better understand a complex older patient in New Zealand, with significant relevance also for international geriatric care and to establish an effective acute geriatric care model that leads to beneficial health outcomes and provides safeguard mechanisms. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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