Prevalencia de cronicidad y multimorbilidad en la población cubierta por el servicio público de teleasistencia de Euskadi: impacto en costes y calidad de la atención / Prevalence and costs of chronicity and multimorbidity in the population covered by the Basque public telecare service

Fundamento. La teleasistencia pública en Euskadi (betiON) es un servicio ofrecido por el Departamento de Empleo y Políticas Sociales del Gobierno Vasco que proporciona atención telefónica a las poblaciones dependientes y de mayor edad, ofreciéndoles comunicación con un centro de atención. Su conexión con dispositivos asistenciales sanitarios permite disponer de sistemas de información que comparten datos de índole sanitaria y social, lo cual posibilita una caracterización de la población atendida y el desarrollo de modelos de provisión integrada social y sanitaria. Objetivo. Describir la distribución de enfermedades crónicas y multimorbilidad entre los usuarios de betiON, estimar el coste de su atención sanitaria, calcular las hospitalizaciones evitables y comparar tales indicadores con la población general. Métodos. Se extrajo información de las bases de datos sanitarias públicas y de betiON. Se caracterizó la población de teleasistencia mayor de 65 años de edad (N=23.742) respecto a variables demográficas, socio-económicas, carga de morbilidad, costes y hospitalizaciones evitables. Se realizaron ajustes indirectos por edad y sexo para comparar la prevalencia de enfermedades con la población general y modelos de regresión para coste y hospitalizaciones evitables. Resultados. En la población de teleasistencia, el promedio de edad es 83 años, el 80% son mujeres, un 55,1% viven solos y residen en zonas más deprimidas. El 42,5% de los varones y 36,5%de las mujeres está afectado por 5 o más patologías crónicas, siendo 4,06 el promedio de enfermedades por persona. Además los costes de su atención sanitaria son más elevados que los de la población general (57%). Ajustando por edad, sexo y morbilidad, no existen diferencias en la tasa de hospitalizaciones evitables con la población general. Conclusiones. Los usuarios de teleasistencia presentan mayor carga de morbilidad, mayor necesidad de atención y condiciones sociales más desfavorables, pese a lo cual la calidad de la atención recibida es equiparable a la población general. La coordinación de servicios sociales y sanitarios a través de la conexión de sistemas de información y la teleasistencia como plataforma de servicios ofrecen oportunidades relevantes de innovación en la intervención sobre esta población (AU)

Background. The public telecare service in Euskadi (betiON)is a service offered by the Department of Employment and Social Policy of the Basque Government and offers telephone support to elderly and disabled populations, providing communication with an assistance centre. This connection with healthcare devices allows implementing shared information systems with health and social data, which enable a characterization of the attended population and the development of integrated models for health and social provision. Objective. To describe the distribution of chronic diseases and multimorbidity among users of betiON, to estimate the cost of their health care and to compare these indicators with those of the general population. Methods. We extracted information from betiON and public healthcare databases. We characterized telecare population above 65 years (N = 23.742) and compared it with the total Euskadi one (N = 2.262.707) with respect to demographic, socio-economic burden, costs and ambulatory care sensitive conditions. Results. In the telecare population, the average age is 83 years, 80% are women, 55,1% live alone and dwell in poorer neighborhoods. A 42,5% of males and 36,5% of women are affected by five or more chronic conditions, averaging 4,06 pathologies per person. Also they exhibit higher healthcare costs than the general population. Conclusions. Telecare users have a higher disease burden, greater need for healthcare and unfavorable social conditions. Telecare provides an opportunity for innovation and intervention, through coordination of social and healthcare services (AU)

[Prevalence and costs of chronicity and multimorbidity in the population covered by the Basque public telecare service]. / Prevalencia de cronicidad y multimorbilidad en la población cubierta por el servicio público de teleasistencia de Euskadi: impacto en costes y calidad.

BACKGROUND: The public telecare service in the Basque Autonomous Community (betiON) is a service offered by the Department of Employment and Social Policy of the Basque Government and offers telephone support to elderly and disabled populations, providing communication with an assistance centre. This connection with health care devices makes it possible to implement shared information systems with health and social data, which enable a characterization of the population attended to and the development of integrated models for health and social provision. OBJECTIVE: To describe the distribution of chronic diseases and multimorbidity among users of betiON, to estimate the cost of their health care and to compare these indicators with those of the general population. METHODS: We extracted information from betiON and public healthcare databases. We characterized the telecare population above 65 years (N = 23.742) and compared it with the total population in the Basque Autonomous Community (N = 2.262.707) with respect to variables in demography socio-economic burden, costs and ambulatory care conditions. RESULTS: In the telecare population, the average age is 83 years, 80% are women, 55.1% live alone and reside in poorer neighbourhoods. Forty-two point five per cent of males and 36.5% of women are affected by five or more chronic conditions, averaging 4.06 pathologies per person. They also show higher healthcare costs than the general population. CONCLUSIONS: Telecare users have a higher disease burden, greater need for healthcare and unfavourable social conditions. Telecare provides an opportunity for innovation and intervention, through the coordination of social and healthcare services.

[Current and suitable organization of the Basque Health System. Opinion of the managing level]. / Cultura organizativa actual e idónea del Sistema Vasco de Salud. Opinión del nivel directivo.

Osasuna Zainduz (caring our health), a planned change tor the public health care services, is being implemented in the Basque Country. A questionnaire discriminant terms passed to all the managers of the Basque Health Service is analysed to assess its actual and optimum organizational culture. We looked at significant differences between means, comparing actual and optimum profiles. All the differences of means were highly significant (P < 0.00001); performance based salaries (6.19) and identification with the organization (5.82) were the highest. New management styles based on information and communication, tolerance with conflicts and risks, as well as support from managers were identified through regression analysis as key success criteria for such our organization.