Keywords: Primary Care, Home health care, Integrated care, Person-centred care
Background:
As the elderly population grows, healthcare has moved from hospitals directly to people's homes, where multiple healthcare providers facilitate care. Strong and integrated primary care and home care are fundamental components of an effective management of chronic and degenerative diseases in rural areas, and allow to reduce emergency room visits and hospital admissions.
Aim of the study:
How is integrated home care (IHC) provided to the elderly and patients with special needs in our rural areas?
Methodology:
Retrospective observational cohort study, which investigated a population sample in a rural area of the province of Pordenone, in North East Italy. The data relating to the quantity and type of IHC services provided (from January 1st to December 31st, 2023) were extracted from the Local Health Authority database.
Results:
Total population in the area (200 Km²), 14554 (3868 over 65 yo, 27%). General Practitioners (7), Family nurses (5), patients treated at home: 402 (27.7 x 1000 inhabitants, 90% > 65 yo), female 251 (63%), male 151 (37%). GPs’ home visits around 1500 (based on 2018 data), nurses home visits (7333), for a total of 20,223 services. The majority of patients are affected by heart failure (17.3%) and malignant tumors (9.4%). Type of services provided: wound dressing (vascular/pressure/diabetic ulcers): 6135; therapeutic education (patient/caregiver): 1970; blood withdrawal: 1047; nasogastric tube/PEG management: 503; parenteral nutrition management: 388; bladder catheterization management: 351; i.v. therapy: 340.
Conclusions:
The IHC in this rural area involved GPs, nurses, physical therapists, social workers, palliative care doctors, dieticians and psychiatrists. Such a comprehensive primary health care system showed to be a positive reality, for a person-centred care. Further studies would be useful to evaluate the level of satisfaction of patients and their caregivers.
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