JavaScript is disabled for your browser. Some features of this site may not work without it.

    Listar

    Todo RIUMAComunidades & ColeccionesPor fecha de publicaciónAutoresTítulosMateriasTipo de publicaciónCentrosEsta colecciónPor fecha de publicaciónAutoresTítulosMateriasTipo de publicaciónCentros

    Mi cuenta

    AccederRegistro

    Estadísticas

    Ver Estadísticas de uso

    DE INTERÉS

    Datos de investigaciónReglamento de ciencia abierta de la UMAPolítica de RIUMAPolitica de datos de investigación en RIUMASHERPA/RoMEODulcinea
    Preguntas frecuentesManual de usoDerechos de autorContacto/Sugerencias
    Ver ítem 
    •   RIUMA Principal
    • Investigación
    • Enfermería - (ENF)
    • ENF - Contribuciones a congresos científicos
    • Ver ítem
    •   RIUMA Principal
    • Investigación
    • Enfermería - (ENF)
    • ENF - Contribuciones a congresos científicos
    • Ver ítem

    Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

    • Autor
      Morales-Asencio, José MiguelAutoridad Universidad de Málaga; Cejudo Lopez, Angela; Silvano Arranz, Agustina; Palacios Gómez, Leopoldo; Cuevas-Fernández-Gallego, María MagdalenaAutoridad Universidad de Málaga; Kaknani-Uttumchandani, ShakiraAutoridad Universidad de Málaga
    • Fecha
      2016-08-30
    • Palabras clave
      Enfermedades crónicas
    • Resumen
      Background: Complex chronic diseases are a challenge for the current configuration of Health services. Case management is a service frequently provided for people with chronic conditions and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures, and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers, and services used. Methods and design: The study was divided into three phases, covering the detection of information needs, the design and its implementation in the healthcare system, using literature review and expert consensus methods to select variables that would be included in the registry. Objective: To describe the essential characteristics of the provision of ca re lo people who receive case management (structure, process and outcomes), with special emphasis on those with complex chronic diseases. Study population: Patients from any District of Primary Care, who initiate the utilization of case management services, to avoid information bias that may occur when including subjects who have already been received the service, and whose outcomes and characteristics could not be properly collected. Results: A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. Total sample was composed of 427 patients, of which 211 (49.4%) were women and 216 (50.6%) were men. The average functional level (Barthel lndex) was 36.18 (SD 29.02), cognitive function (Pfeiffer) showed an average of 4.37 {SD 6.57), Chat1son Comorbidity lndex, obtained a mean of 3.03 (SD 2.7) and Social Support (Duke lndex) was 34.2 % (SD 17.57). More than half of patients include in the Registry, correspond lo immobilized or transitional care for patients discharged from hospital (66.5 %). The patient's educational level was low or very low (50.4%). Caregivers overstrain (Caregiver stress index), obtained an average value of 6.09% (SD 3.53). Only 1.2 % of patients had declared their advanced directives, 58.6 had not defined the tutelage and the vast majority lived at home 98.8 %. Regarding the major events recorded at RANGE Registry, 25.8 % of the selected patients died in the first three months, 8.2 % suffered a hospital admission at least once time, 2.3%, two times, and 1.2% three times, 7.5% suffered a fall, 8.7% had pressure ulcer, 4.7% had problems with medication, and 3.3 % were institutionalized. Stroke is the more prevalent health problem recorded (25.1%), followed by hypertension (11.1%) and COPD (11.1%). Patients registered by NCMs had as main processes diabetes (16.8%) and dementia (11.3 %). The most frequent nursing diagnoses referred to the self-care deficit in various activities of daily living. Regarding to nursing interventions, described by the Nursing Intervention Classification (NIC), dementia management is the most used intervention, followed by mutual goal setting, caregiver and emotional support. Conclusions: The patient profile who receive case management services is a chronic complex patient with severe dependence, cognitive impairment, normal social support, low educational level, health problems such as stroke, hypertension or COPD, diabetes or dementia, and has an informal caregiver. At the first follow up, mortality was 19.2%, and a discrete rate of readmissions and falls.
    • URI
      http://hdl.handle.net/10630/11927
    • Compartir
      RefworksMendeley
    Mostrar el registro completo del ítem
    Ficheros
    Poster ICCHNR Kent.pdf (970.5Kb)
    Colecciones
    • ENF - Contribuciones a congresos científicos

    Estadísticas

    Ver Estadísticas de uso
    Buscar en Dimension
    REPOSITORIO INSTITUCIONAL UNIVERSIDAD DE MÁLAGA
    REPOSITORIO INSTITUCIONAL UNIVERSIDAD DE MÁLAGA
     

     

    REPOSITORIO INSTITUCIONAL UNIVERSIDAD DE MÁLAGA
    REPOSITORIO INSTITUCIONAL UNIVERSIDAD DE MÁLAGA