Early intervention in health problems identified by home helps among elderly subjects
Anette Hylen Ranhoff
Bok Engelsk 1997
| Utgitt | 1997
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| Omfang | 16 s. + vedl.
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| Opplysninger | Abstract: Objective - To study the effect of early intevention in health problems identified by home helps. Design - Open study with quasi-experimental design. The clients of home helps were the subjects, but randomization took place at the level of the organizational units of home helps. Setting - Community health sservices and hospital-based general practitioner. Subjects - Home help clients, 75 years or older, 113 intervention subjects and 161 controls. Intervention - Home helps were thaught to recognize cases and asked to call the study doctor when new medical or functional problems occurred. The intervention lasted for two years with an additional year for observation. Main outcome measures - Causes of referral, ICD-9 diagnostic categories, time under surveillance before long-term care of death, use of community services and hospital bed. Results - 51 (45.1%) of the intervention subjects were referred; 110 referrals in all. General loss of function was most frequent cause, and in all but six referrals specific diagnoses were made. Home helps`referrals of patients with infection and stroke corresponde with the final diagnoses. After the first year of the study, the percentage of subjects counting to live home was higher in the intervention group (p=0.05 after adjustment for base-line differences in age and gender), mortality similar, and use of hospital bed higher in intervention group. Conclusions - Home helps can detect and communicate to a doctor functional decline and clinical manifestations of disease among their elderly clients. The study indicated but provided no definite evidence that direct referral from home helps to hospital-based general practitioner can keep elderly people at home longer.
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