La hospitalización domiciliaria del paciente agudo: un nuevo enfoque de cuidados / Home hospitalization of the acute patient: a new approach to care

La hospitalización a domicilio (HAD) pediátrica tiene como objetivo proveer al paciente y a su familia de una alternativa a la hospitalización convencional, de forma segura y eficaz, mejorando la calidad de vida del paciente y su familia. Las patologías más frecuentes en HAD de paciente agudo pediátrico son la patología respiratoria aguda y las infecciones bacterianas que precisan antibioterapia parenteral. El éxito de un programa de hospitalización domiciliaria de paciente agudo recae en la adecuada selección de pacientes y la exhaustiva capacitación de los cuidadores, así como en una buena comunicación y coordinación entre los diferentes servicios y niveles de atención implicados.(AU)

Pediatric hospitalization at home (HAH) aims to provide the patient and his family with an alternative to conventional hospitalization, safely and effectively, improving the quality of life of the patient and his family. The most frequent pathologies in HAH in pediatric acute patients are acute respiratory pathology and bacterial infections that require parenteral antibiotic therapy. The success of an acute patient home hospitalization program relies on the proper selection of patients and exhaustive training of caregivers, as well as good communication and coordination between the different services and levels of care involved.(AU)

Effectiveness of e-Health cardiac rehabilitation program on quality of life associated with symptoms of anxiety and depression in moderate-risk patients.

Exploring new models of medical care requires evaluating the impact of new care strategies not only on physiological parameters but also on the quality of life of the patient. On the other hand the presence of anxiety together with depression requires further consideration when planning appropriate management strategies. The aim of this study was to examine the effectiveness of a home-based cardiac rehabilitation program incorporating an e-Health technology on health-related quality of life associated with symptoms of anxiety and depression in moderate-risk patients. A multicenter, randomized controlled clinical trial was designed to compare a traditional hospital based cardiac rehabilitation program (n = 38, 35 male) with a mixed home surveillance program where patients exercised at home with a remote electrocardiographic monitoring device (n = 33, 31 male). The Short Form-36 (SF-36) Health Survey and the Goldberg questionnaire were used to evaluate quality of life and the presence of symptoms of anxiety and depression respectively. The results of this study show that the type of cardiac rehabilitation program did not influence the improvement in quality of life (p = 0.854), but the presence of symptoms of anxiety and depression did (p = 0.001). Although both programs achieved a decrease in anxiety and depression symptoms and improved functional capacity (p ≤ 0.001), a significant interaction effect was found between the group with or without anxiety and depression symptoms and the type of program in the bodily pain dimension (p = 0.021). Trial registration: Retrospectively registered NCT02796404 (10/06/2016) in clinialtrials.gov.

Calidad de vida de las personas adultas con nutrición parenteral ingresadas en hospitalización domiciliaria: revisión sistemática / Quality of life of adult people with parenteral nutrition admitted to home hospitalization: systematic review

OBJETIVO: Revisar la documentación científica relacionada con la calidad de vida de las personas adultas con nutrición parenteral ingresadas en hospitalización domiciliaria. MÉTODO: Revisión crítica y sistemática. Los datos se obtuvieron de la consulta a las siguientes bases de datos bibliográficas: MEDLINE (vía PubMed), Cochrane Library, Embase, Scopus y Web of Science. Los términos utilizados, como descriptores y como texto en los campos de registro del título y el resumen, fueron "Home Care Services", "Parenteral Nutrition" y "Quality of Life", utilizando los filtros «Humans», «Adult: 19+ years» y «Clinical Trial». Fecha de la búsqueda febrero de 2020. La calidad documental de los artículos se evaluó mediante el cuestionario CONSORT. RESULTADOS: De las 379 referencias recuperadas, tras depurar las repeticiones y aplicar los criterios de inclusión y exclusión, se seleccionaron 7 ensayos clínicos. En 3 (43%) de los ensayos revisados se observó una mejora en relación a la calidad de vida. Las puntuaciones obtenidas mediante el cuestionario CONSORT, oscilaron entre 12,5 y 20,5 sobre una puntuación máxima de 24. CONCLUSIONES: El incremento de la calidad de vida de los enfermos con NPD está directamente relacionado con la del estado y soporte nutricional de los mismos. Se observó una mejor calidad de vida en los pacientes con bomba portátil y en los que se administró teduglutida. El adecuado manejo del catéter y la consecuente disminución de las infecciones también contribuyó a la mejora de la calidad de vida de las personas con NPD

OBJECTIVE: To review the scientific documentation related to the quality of life of adult people with parenteral nutrition admitted to home hospitalization. METHOD: Critical and systematic review. The data were obtained from the consultation of the following bibliographic databases: MEDLINE (via PubMed), Cochrane Library, Embase, Scopus y Web of Science. Terms used as descriptors and as text in the title and summary record fields were: "Home Care Services", "Parenteral Nutrition" and "Quality of Life", using the filters «Humans», «Adult: 19+ years» y «Clinical Trial». Search date February 2020. The documental quality of the articles was evaluated by using the CONSORT questionnaire. RESULTS: From 379 recovered references, after refining the repetitions and applying the inclusion and exclusion criteria, 7 clinical trials were selected. In 3 (43%) of the revised trials it was observed an improvement in relation to the quality of life. The scores obtained by the CONSORT questionnaire were from 12.5 to 20.5 with a maximum score of 24. CONCLUSIONS: The parenteral support of patients with home parenteral nutrition (HPN) was directly related to the nutritional status, and it corresponded with an increase in quality of life. An improvement of quality of life was proved in patients that used portable pump and it was likewise proved that the use of teduglutide was beneficial for the quality of life. The correct handle of the catheter and the reduction of infections were also connected with the enhancement of the quality of life of people with HPN

La revista Hospital a Domicilio incluida en SciELO / The journal Hospital a Domicilio included in SciELO

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Cuidados paliativos para pacientes con insuficiencia respiratoria crónica / Palliative care for patients with chronic respiratory failure

La creciente prevalencia de enfermedades respiratorias crónicas y su más larga supervivencia han motivado que aumente el número de pacientes en situación avanzada de la enfermedad y en techo terapéutico. Sin embargo, este hecho epidemiológico no se ha acompañado de un desarrollo paralelo de programas de cuidados paliativos, lo que motiva que los enfermos que se encuentran en esta situación no reciban los cuidados médicos óptimos para asegurar su confort y evitar ingresos sucesivos que poco aportan a su pronóstico y calidad de vida. La experiencia del Hospital Lucus Agusti revela que el 7% del total de ingresos de neumología corresponden a pacientes con enfermedad crónica respiratoria avanzada no neoplásica, que solo el 65% de ellos reciben tratamiento paliativo de sus síntomas y que la práctica totalidad fallece en el hospital. Es necesario poner en práctica proyectos que no solo involucren a neumólogos, sino también a personal de enfermería, médicos de atención primaria, de hospitalización a domicilio y personal del hospital de día

The increasing prevalence of chronic respiratory diseases and the longer survival of patients with these disorders have lead to a rise in the number of individuals in a terminal condition with no chances of responding to additional medication. Nevertheless, this epidemiological fact has not been accompanied by a parallel development of palliative care programmes, and this prevents the patients from receiving optimal medical care to ensure their well-being and to avoid further unnecessary admissions to hospital. Our local experience in the Lucus Augusti University Hospital reveals that 7% of the admissions to the respiratory ward correspond to patients with advanced and non-neoplastic chronic respiratory disorders. Only 65% of these patients benefit from a well-structured palliative care plan and practically all of them die in the hospital. Altogether, these data highlight the need for a strategy that involves not only pneumologists but also general practitioners, nurses and palliative care physicians

El médico clínico ante el paciente en el final de sus días / The clinician and their patient at the end of life

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Paediatric fracture clinic re-design: Incorporating a virtual fracture clinic.

INTRODUCTION: The use of virtual fracture clinics (VFCs) and home management protocols is increasing. The main aim of this research is to determine whether a paediatric home management programme and VFC can be used safely to manage a range of suitable fractures in children. MATERIALS AND METHODS: Protocols for the home management of stable paediatric fractures were designed by two consultant paediatric orthopaedic surgeons. These were for children between the ages of 18 months and 15 years 364 days. A new tariff was negotiated with the clinical commissioning groups (CCGs) for a VFC new patient review. A prospective analysis was performed for the first 2 months of the programme. Further review periods were undertaken 6 months later and 12 months after that. RESULTS: Sixty-five patients were reviewed in the first 10 VFCs (mean 6.5 cases per week). After 6 months, 164 patients were reviewed in a 3-month period in the VFC, a mean of 11 cases per week. A year later the number of patients reviewed in the VFC had continued to increase with a total of 253 patients in 3 months, mean 21 cases per week. This gave a saving to the CCG of £45,000 per year and to the hospital of £106,000 per year. There were no serious adverse consequences to any patients from the use of the pathway. DISCUSSION AND CONCLUSION: We have reported on the introduction of a paediatric VFC and a home management programme for stable paediatric fractures. We are not aware of any reports in the orthopaedic literature that have described such a comprehensive and innovative re-organisation of paediatric fracture services. We estimate that the NHS could save approximately £10.1 million if all hospitals in England introduced this.

Primer caso de administración de ceftazidima/avibactam en hospitalización a domicilio. Bacteriemia por Klebsiella pneumoniae BLEE multirresistente / First case of ceftazidime/avibactam administration in home care. ESBL producing Klebsiella pneumoniae bacteremia

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[Serious game, a link between institution and home]. / Le serious game, un lien entre institution et domicile.

Serious game is a personal innovative technology to facilitate learning and social interaction. It can be used in a patient's home or in an institution. This training tool can also be developed for health professionals, especially accommodation facilities for the elderly. The objective is to integrate knowledge and know-how.

[Connected home, monitoring and improved care]. / Domicile connecté, suivi et soins améliorés.

New technologies offer a new approach to healthcare management that benefits the patient, especially at home: better living spaces, improved safety and preservation of communication. Professionals concerned and family caregivers should be trained in these new technologies to discover and explore everyday their possibilities and uses.

Experiencias de cuidado cultural en personas con diabetes y el contexto familiar, con enfoque Leininger / Experiências culturais em cuidados com diabetes e contexto familiar, com foco Leininger Cultural / Experiences in diabetes care and family context, focusing Leininger

Objetivo: Describir experiencias de cuidado desde lo cultural de personas con diabetes Mellitus tipo II en su contexto familiar atendidos en un Hospital de III nivel durante 2013 y 2014. Metodología: Enfoque cualitativo tipo etnográfico, etnoenfermería, derivada de la Teoría de enfermería de Madeleine Leininger. Muestreo no probabilístico a conveniencia con 10 informantes clave, 6 informantes generales. Recolección de información mediante entrevistas abiertas a profundidad en el hogar, notas de campo. Análisis de información a través de las fases de la etnoenfermería: codificación, categorización, identificación de patrones recurrentes, temas. Resultados: se identificaron cinco tema principales: Reacción a su situación de enfermedad, la participación de la familia, experiencias producidas desde el servicio de salud y otros actores sociales, efectos percibidos y conocidos por sí mismo, construcción del cuidado. Conclusión: La experiencia de cuidado en las personas con diabetes en el contexto familiar determina patrones de cuidado que inciden culturalmente y reflejan su cuidado en el hogar. La investigación desde lo cultural, fortalece la práctica de enfermería porque potencia un campo natural de cuidado para brindar cuidado culturalmente congruente (AU)

To describe experience of care from culture of people with type II diabetes mellitus in the family context treated at a hospital in Ibague III level during 2013 and 2014. Methodology: qualitative ethnographic approach, ethnonursing derived from the Theory of nursing Madeleine Leininger. Non-probability convenience with 10 key informants, informants 6 general sampling. Gathering information through open deep in the home, field notes and observation interviews. Analysis of information through the phases of the ethnonursing: coding, categorizing, identifying recurring patterns, themes. Results: Reaction to the disease situation, the involvement of family, experiences produced from the health service and other social actors, perceived and known by itself effects, construction of care: five major topic were identified. Conclusion: The experience of diabetes care in the family context determines patterns of care that reflect their influence culturally and home care. Research from the cultural, strengthens nursing practice because it enhances a natural field of care to provide culturally congruent care (AU)

Para descrever a experiência dos cuidados de cultura de pessoas com diabetes mellitus tipo II no contexto familiar tratados em um hospital de nível III Ibague durante 2013 e 2014. Metodologia: abordagem etnográfica qualitativa, etnoenfermagem derivado da Teoria de enfermagem Madeleine Leininger. Conveniência não probabilística com 10 informantes-chave, os informantes 6 de amostragem geral. Coleta de informações por meio de profundidade aberto em casa, notas de campo de observação e entrevistas. Análise de informações através das fases do etnoenfermagem: codificação, categorização, identificação de padrões recorrentes, temas. Resultados: A reação à situação da doença, o envolvimento dos familiares, as experiências produzidas a partir do serviço de saúde e outros atores sociais, percebido e conhecido por si só, efeitos, construção do cuidado: cinco dos principais tópicos foram identificados. Conclusão: A experiência de cuidados com diabetes no contexto familiar determina padrões de cuidados que afetam cultural e reflectem os seus cuidados em casa. Pesquisa da cultural, fortalece a prática de enfermagem porque melhora um campo natural de cuidado para prover um cuidado culturalmente congruente (AU)

Long-Term Respiratory Support for Children and Adolescents in Austria: A National Survey.

BACKGROUND: Population-based data on pediatric patients on long-term respiratory support (LTRS) in Austria are lacking. This study aimed to record the pediatric departments active in this field, as well as number and characteristics of patients on LTRS. METHODS: A national cross-sectional study was carried out by means of questionnaires sent to all pediatric departments in Austria. RESULTS: All departments answered to the questionnaires. On June 1st, 2013, the reference day for this study, 12 of the 41 pediatric departments in Austria were active in the field. At this time, these centers were caring for 143 patients, 111 (77.6%) of them under 18 years, which corresponds to a prevalence of 7.4 per 100 000. The patients suffered from neuromuscular disorders (44%), other neurological disorders (18.9%), disorders of respiratory drive (9.1%), obstructive sleep apnea (8.4%), thoracal and spinal diseases (8.4%), pulmonary disorders (4.9%) and other diseases (6.3%). Continuous positive airway pressure was used in 6.3%, non-invasive ventilation in 60.1% and invasive ventilation in 33.6% of the patients, respectively. LTRS was performed at home in 92.3%. CONCLUSION: LTRS represents a common management strategy in children and adolescents with a variety of disorders. Census reports such as this one provide the basis for appropriate planning of resource allocation. The age distribution of our patients shows the need for structured transition into adult care.

The evolution of home enteral nutrition (HEN) in Poland during five years after implementation: a multicentre study / Evolución de la nutrición enteral domiciliaria (HEN) en Polonia durante cinco años después de su implantación: un estudio multicéntrico

Background: home enteral nutrition (HEN) is the best option for chronic. patients without the ability to swallow, but with intact digestive tract. Despite the increasing use of home enteral tube feeding (HETF), there is little published information about the types of patients receiving home enteral nutrition. The purpose of this paper to present the evolution of HETF. Material and methods: the retrospective multicenter observational study was performed using questionnaires, which were distributed among the biggest Polish HEN centres. The study covered all patients treated between January, 2007 and January, 2014. Results: in total 196 adult patients in 2008 (M:104. F: 92, mean age 58.1 [41-75]) and 2842 in 2013 (M: 1541, F: 1301, mean age 61.4 range: 1-91) were assessed. The number of patients grew significantly between 2008 and 2013 (p0.05). Percutaneous endoscopic gastrostomy was the most common GI access (>60%), its use and the use of gastrostomies increased significantly since 2008 (p <0.05). Although the reimbursement for HETF started in 2007, HEN centres expressed doubts about unclear rules for the qualification to HEN and its use. Conclusions: HETF is a safe, well-tolerated and cost-effective procedure. The profile of patients and techniques may vary at the beginning, but becomes similar to other HETF countries relatively soon. The number of patients grows quickly, and that fact suggests that the prevalence of HETF is similar in all countries (AU)

Antecedentes: el inicio con nutrición enteral (HEN) es la mejor opción para los pacientes crónicos sin capacidad de tragar, pero con el tracto digestivo intacto. A pesar del aumento en el uso de la alimentación por sonda enteral domiciliaria (HETF), hay poca información publicada sobre los tipos de pacientes que reciben nutrición enteral domiciliaria. El propósito de este trabajo es presentar la evolución de HETF. Material y métodos: el estudio observacional multicéntrico retrospectivo se realizó mediante cuestionarios que se distribuyeron entre los mayores centros HEN polacos. El estudio abarcó a todos los pacientes tratados entre enero de 2007 y enero de 2014. Resultados: en total fueron evaluados 196 pacientes adultos en 2008 (M: 104 F: 92, edad media 58,1 [41-75]) y 2.842 en 2013 (M: 1541, F: 1.301, con una edad media de 61,4 rango: 1-91). El número de pacientes aumentó significativamente entre 2008 y 2013 (p0,05). La gastrostomía endoscópica percutánea fue el acceso GI más frecuentes (>60%), su uso y el uso de gastrostomías aumentó significativamente desde 2008 (p< 0,05). Aunque el reembolso de HETF comenzó en 2007, los centros de HEN expresaron dudas sobre las reglas poco claras para la calificación para HEN y su uso. Conclusiones: HETF es un procedimiento seguro, bien tolerado y rentable. El perfil de los pacientes y las técnicas puede variar al principio, pero se vuelve similar a otros países HETF relativamente pronto. El número de pacientes crece rápidamente, y ese hecho sugiere que la prevalencia de HETF es similar en todos los países (AU)

Hospitalización domiciliaria en el paciente anciano: revisión de la evidencia y oportunidades de la geriatría / Hospital-at-home in older patients: a scoping review on opportunities of developing comprehensive geriatric assessment based services

Presentamos una scoping review sobre el interés que puede tener desarrollar en nuestro sistema sanitario nuevos esquemas de hospitalización domiciliaria en pacientes ancianos con condiciones complejas asociadas a procesos agudos de salud. Se realizó una búsqueda bibliográfica de ensayos clínicos aleatorizados, revisiones sistemáticas y metaanálisis de los mismos en Pubmed y Cochrane Library, desde enero de 1990 a julio de 2013. La búsqueda incluyó los términos hospital-at-home, Early Supported Discharge, hospital in the home y home hospitalization. Se analizaron: modelo de intervención (sustitutivo del ingreso o facilitador del alta), edad, diagnóstico principal, perfiles de pacientes incluidos y tipo de intervención (disciplinas implicadas, duración de la intervención y principales objetivos y resultados). Concluimos que hay diversos modelos de hospitalización domiciliaria con resultados clínicos favorables. Aparte de esquemas sanitarios centrados en agudizaciones de enfermedades crónicas en ancianos más jóvenes, mayoritarios en nuestro país, destacan otros esquemas integrales basados en equipos interdisciplinares de base geriátrica orientados a intervenciones complejas. El desarrollo de esquemas de hospitalización domiciliaria integral, con equipos liderados por geriatras, es una oportunidad como alternativa a la hospitalización convencional adaptada a pacientes ancianos en nuestro entorno asistencial (AU)

This scoping review focused on the opportunity of developing new hospital-at-home schemes in our health systems adapted to older patients with complex conditions due to acute illness. A review was conducted on articles including, randomized controlled trials, systematic reviews and meta-analysis in PubMed and Cochrane Library, from January 1990 to July 2013. Search terms were: hospital-at-home, Early Supported Discharge, hospital in the home and home hospitalization. An analysis was performed to include: the intervention model (admission avoidance or early discharge), age, diagnosis, main inclusion criteria and intervention characteristics (disciplines involved, duration of intervention, main outcomes and objectives). It is concluded that there are several models of hospital-at-home care, with favorable clinical outcomes. The majority of teams in our country focused on acute health care in the less elderly with chronic diseases. Other schemes based on comprehensive geriatric assessment and interdisciplinary teams specialized in complex interventions are also highlighted. The development of comprehensive geriatric assessment based hospital-at-home care by teams led by geriatricians is an opportunity to develop alternatives to conventional hospitalization interventions tailored to older patients (AU)

[The current state, the possibilities and difficulties of palliative and hospice care in Hungary]. / A hazai hospice- és palliatív ellátás helyzete, lehetoségei, nehézségei.

Hospice-palliative care has existed in Hungary for more than 20 years but physicians know very little about it. The objective of the study is to give detailed practical information about the possibilities and the reasonability of hospice care and the process of how to have access to it. The authors review and analyze the database of the national Hospice-Palliative Association database to provide most recent national data on hospice-palliative care. In addition, legal, financial and educational issues are also discussed. At present there are 90 active hospice providers in Hungary, which provide service for more than 8000 terminally ill cancer patients. According to WHO recommendations there would be a need for much more service providers, institutional supply and more beds. There are also problems concerning the attitude and, therefore, patients are admitted into hospice care too late. Hospice care is often confused with chronic or nursing care due to lack of information. The situation may be improved with proper forms of education such as palliative licence and compulsory, 40-hour palliative training for residents. The authors conclude that a broad dissemination of data may help to overcome misbeliefs concerning hospice and raise awareness concerning death and dying.

Barreras y facilitadores arquitectónicos: un desafío para la independencia funcional / Architectural barriers and facilitators: a challenge to the functional independence

La dependencia es resultante de la disfunción, limitación de la actividad y restricciones en la participación social. Los factores ambientales pueden actuar como facilitadores o barreras. Objetivos: Enseñar barreras y facilitadores de las personas dependientes en los hogares e identificar quién realiza las acciones de atención. Métodos: Estudio transversal, descriptivo y exploratorio realizado entre marzo y julio de 2012. La muestra estuvo conformada por 33 personas y fue aprobada por el Comité de Ética de Investigación con el número 23.914. Resultados: La población es mayoritariamente femenina (55%) y 82% de ellos son ancianos. Había trece tipos de barreras arquitectónicas y hasta siete en una misma casa. El 46% tenía más de dos barreras arquitectónicas. El 21% de los hogares no ha presentado ningún rasgo arquitectónico facilitador. El 77% de los cuidadores son mujeres, en su mayoría hijos (44%). Conclusión: El conocimiento de las barreras y facilitadores en los hogares de las personas con algún tipo de dependencia es esencial para el cuidado de la salud, que debe centrarse en la autonomía y la calidad de vida de las personas

The dependence results from dysfunction, limitation of activities and restriction in social participation. The environmental factors can act as facilitators or barriers. Objectives: To point out barriers and facilitators at dependent people' homes and identify who performs care actions. Methodology: Cross-sectional, descriptive and exploratory research conducted from March to July 2012. The sample consisted of 33 people and it was approved by the Research Ethics Committee - platform Brazil under the number 23914. Results: The population is predominantly female (55%) and 82% of them are elderly. There were thirteen types of architectural barriers, up to seven in the same household. 46% had more than two architectural barriers and 21% of the households did not present any facilitator and architectural resource. Seventy seven per cent of the caregivers are female and mostly sons (44%). Conclusion: The knowledge of the barriers and facilitators in the homes of people with some kind of dependence is essential for health care. This should aim the individuals' autonomy and life quality

Comparación de la satisfacción de los usuarios de atención domiciliaria: modelo integrado vs. modelo dispensarizado / Comparison of level of satisfaction of users of home care: Integrated model vs. dispensaries model

OBJETIVO: Comparar el grado de satisfacción de los usuarios que reciben atención domiciliaria a través de 2 modelos de atención primaria: integrado y dispensarizado. DISEÑO: Estudio transversal, observacional. Emplazamiento: Dos centros de atención primaria de la provincia de Barcelona. Participantes: Ciento cincuenta y ocho pacientes crónicos mayores de 65 años que recibían atención domiciliaria: 67 mediante el modelo integrado y 91 mediante el modelo dispensarizado. Mediciones principales: Se administró la escala de Evaluación de la Satisfacción del Servicio de Atención Domiciliaria (SATISFAD-12), así como preguntas complementarias relacionadas con la satisfacción del servicio de atención domiciliaria y características sociodemográficas. RESULTADOS: Los usuarios del modelo dispensarizado estaban más satisfechos que los del modelo integrado. Existía una mayor continuidad asistencial en el modelo dispensarizado y un menor porcentaje de ingresos hospitalarios en el último año. La satisfacción de los usuarios de ambos modelos no estaba asociada al género ni a la percepción de salud y autonomía por parte del paciente. CONCLUSIONES: El grado de satisfacción de los pacientes de atención primaria domiciliaria parece depender de las características propias de cada modelo organizativo, siendo el modelo dispensarizado el que presenta un mayor grado de satisfacción o calidad asistencial percibida. Se debería realizar un mayor número de estudios para generalizar estos resultados a otros centros de atención primaria pertenecientes a otras instituciones

OBJECTIVE: To determine the level of satisfaction of users that receive home health care through two different models of primary health care: integrated model and dispensaries model. DESIGN: cross-sectional, observational study. Location: Two primary care centers in the province of Barcelona. Participants: The questionnaire was administered to 158 chronic patients over 65 years old, of whom 67 were receiving health care from the integrated model, and 91 from the dispensaries model. Main measurements: The Evaluation of Satisfaction with Home Health Care (SATISFAD12) questionnaire was, together with other complementary questions about service satisfaction of home health care, as well as social demographic questions (age, sex, disease, etc). RESULTS: The patients of the dispensaries model showed more satisfaction than the users receiving care from the integrated model. There was a greater healthcare continuity for those patients from the dispensaries model, and a lower percentage of hospitalizations during the last year. The satisfaction of the users from both models was not associated to gender, the health perception, or independence of the. CONCLUSIONS: The user satisfaction rate of the home care by primary health care seems to depend of the typical characteristics of each organisational model. The dispensaries model shows a higher rate of satisfaction or perceived quality of care in all the aspects analysed. More studies are neede to extrapolate these results to other primary care centers belonging to other institutions