ABSTRACT
In this paper, Chappell and Hollander's argument to recognize continuing care as a major component of the healthcare system is applauded. Further justification for looking at prevention and effective treatment of complex, multiple chronic diseases is offered. Finally, the concept of ageism as an important policy issue is further explored.
Subject(s)
Chronic Disease , Delivery of Health Care, Integrated/organization & administration , Health Policy , Health Services for the Aged/organization & administration , Adult , Aged , Attitude , Canada/epidemiology , Delivery of Health Care, Integrated/economics , Evidence-Based Practice , Forecasting , Health Care Costs , Health Services Needs and Demand , Health Services for the Aged/economics , Health Services for the Aged/supply & distribution , Healthy People Programs/economics , Healthy People Programs/organization & administration , Humans , Middle AgedABSTRACT
The amalgamation between two hospitals creates a transition period of significant change, uncertainty and complexity. It is a challenging time within an organization that needs to be managed effectively. This article outlines the integration process and eight-step framework used during an amalgamation of an acute hospital organization and a post-acute hospital. The initial process evaluation and lessons learned are also presented.
Subject(s)
Community Health Services , Cooperative Behavior , Hospitals, Community , Organizational Affiliation/organization & administration , Aged , Community Health Services/organization & administration , Health Services for the Aged , Hospitals, Community/organization & administration , Humans , Ontario , Organizational Case Studies , Quality of Health CareABSTRACT
OBJECTIVE: To determine whether information about an older person's physical functioning provided to the patient and his or her physician delays functional decline and improves health outcomes. DESIGN: A randomized controlled trial was undertaken; the assessors were not blinded to the group allocation. SETTING: The study took place in a clinic within a hospital setting. PARTICIPANTS: Two hundred and sixty-five community-dwelling people over 65 years were recruited from family practice units. INTERVENTIONS: The intervention group received assessments of physical function with feedback to the participant and the participant's family physician or functional assessments alone over 18 months. Self-report measures for health status using the Short Form-36 (SF-36) and preclinical disability were used together with performance measures which included the lower extremity performance test and muscle strength. RESULTS: There were small, statistically significant group/time interactions which included disability scores, F=4.78, P < or =0.05), and the vitality subscale of the SF-36, F=7.47, P < or =0.01). CONCLUSION: Providing information about the results of detailed assessment of physical functioning to older adults and their physicians did not show significant differences in function scores between the intervention and control groups.
