BACKGROUND: Hospital emergency department(ED) use by patients from residential aged care facilities(RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to...BACKGROUND: Hospital emergency department(ED) use by patients from residential aged care facilities(RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to compare patterns of ED use by RACF patients with and without a Hospital in the Nursing Home(Hi NH) program.METHODS: RACF patients presenting to EDs of a hospital with and a hospital without this program during pre- and post-intervention periods were included. Data on patient demographics and ED presentation characteristics were obtained from the Emergency Department Information System database, and were analysed by descriptive and comparative statistics.RESULTS: In both hospitals, most RACF residents presenting to EDs were aged between 75–94 years, female, triaged at scale 3 to 5, and transferred on weekdays and during working hours. Almost half of them were subsequently admitted to hospitals. In accordance with the ICD-10-AM diagnostic coding system, diagnoses that consistently ranked among the top three reasons for visiting the two hospitals before and after intervention included Chapter XIX: injury and poisoning and Chapter X: respiratory diseases. Associated with the intervention, significant decreases in the numbers of presentations per 1 000 RACF beds were identified among patients diagnosed with Chapter XI: digestive diseases [rate ratio(95%CI): 0.09(0.04, 0.22); P<0.0001] and Chapter XXI: factors influencing health status and contact with health services [rate ratio(95%CI): 0.22(0.07, 0.66); P=0.007].CONCLUSION: The Hi NH program may reduce the incidence of RACF residents visiting EDs for diagnoses of Chapter XI and Chapter XXI.展开更多
The present study developed and tested a method to evaluate the location of aged care facilities from the viewpoint of whether they are equitably located for users,using the improved Median Share Ratio(MSR).By evaluat...The present study developed and tested a method to evaluate the location of aged care facilities from the viewpoint of whether they are equitably located for users,using the improved Median Share Ratio(MSR).By evaluating the current location of aged care facilities,it is possible to extract the districts which are short of facilities.The evaluation method was applied to Chofu and Kiyose Cities in Tokyo Metropolis,Japan,and the evaluation result of weighting and that of not weighting by elderly population were compared and discussed.Consequently,adopting the evaluation method with weighting by elderly population,it is possible to adequately examine the districts where new aged care facilities should be constructed.From this evidence,it is significant to evaluate the location of aged care facilities,using the improved MSR with weighting by elderly population in the study.展开更多
Objective:Population ageing in China is a significant challenge for the Chinese government,the society and Chinese people.The dramatic process of population ageing together with social and economic diversity in China ...Objective:Population ageing in China is a significant challenge for the Chinese government,the society and Chinese people.The dramatic process of population ageing together with social and economic diversity in China has created issues in the availability,equality and sustainability of social and financial support for older people.The aims of this review are to identify the social and economic challenges to the traditional caregiving system in China,and to examine possible solutions to improve the care of older people in China using the framework of ageing in place.Methods:Electronic literature searches were conducted in May and June 2013 using PubMed,CNKI,and MEDLINE.Statistical data and reports were retrieved from the United Nations,the World Health Organisation,the World Bank and National Bureau of Statistics of China.Government policy documents were found through government websites and formal publications.Results:Family-centred care for older people in China is recognised as a cultural tradition in the Chinese community.However,driven by large-scale social,political and economic changes,this model of caring for older people has dynamically changed over the last 50 years.Traditionally the family has been the most important source of social support for older people followed by neighbour support and support from friends.Today family obligations of caring are still centred in a cultural and practical context;however,support from family and children has weakened incrementally.Community-based aged services are absent in most areas,while older people and their families have to pay out-of-pocket expenses for non-residential services.There is a severe shortage of aged care or nursing home resources in China and those that exist are of low quality and expensive.The staff who work in these facilities rarely have any formal training in aged care.In addition,a market approach to the funding of residential aged care has the potential to create a moral hazard due to the poor regulatory control of aged care in China.While the building of residential aged care homes is seen as the solution to the care of older people in China,older people prefer to age in their own homes and expect the restoration of the family care tradition as well as more government support for them to“age in place”.This approach has the potential to be more cost effective than expensive aged care facilities.Conclusion:Given older people’s preferences,ageing in place,with the provision of community services and family support,potentially provides a fair and financially viable approach to promote healthy ageing and supportive care in China.Further studies are required to identify 1)how ageing in place can be supported by a national strategy,2)the financial arrangements required to fund such an approach,and 3)how to train high quality community-based professionals in both rural and urban areas to support the care of older people.展开更多
This paper presents a method that combines visibility graph and isovist analyses to investigate the spatia[ and social properties of architectural plans for aged care facilities. The potential of the combined method i...This paper presents a method that combines visibility graph and isovist analyses to investigate the spatia[ and social properties of architectural plans for aged care facilities. The potential of the combined method is examined by measuring the properties of three sets of plans for residential aged care facilities. The first set is a pair of hypothetical, idealized plans, which allegedly reflect the ＂best practice＂ in the industry. The second set comprises a pair of plans for recent Australian designs, and the third set is a pair of plans for South Korean facilities. Results of the computational anatysis of these six plans suggest that social and cultural factors may shape the design of aged care settings and partially explain their international differences. The application of this methodological approach contributes to the understanding of the relation- ship between spaces and their cultural and social properties in the design of aged care facitities.展开更多
基金project is funded by the Queensland Emergency Medicine Research Foundation(QEMRF)(Project ID:QEMRF-PORJ-2009-014,Title:A Comprehensive Evaluation of a Hospital in Nursing Home Program in Three Queensland Hospitals)
文摘BACKGROUND: Hospital emergency department(ED) use by patients from residential aged care facilities(RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to compare patterns of ED use by RACF patients with and without a Hospital in the Nursing Home(Hi NH) program.METHODS: RACF patients presenting to EDs of a hospital with and a hospital without this program during pre- and post-intervention periods were included. Data on patient demographics and ED presentation characteristics were obtained from the Emergency Department Information System database, and were analysed by descriptive and comparative statistics.RESULTS: In both hospitals, most RACF residents presenting to EDs were aged between 75–94 years, female, triaged at scale 3 to 5, and transferred on weekdays and during working hours. Almost half of them were subsequently admitted to hospitals. In accordance with the ICD-10-AM diagnostic coding system, diagnoses that consistently ranked among the top three reasons for visiting the two hospitals before and after intervention included Chapter XIX: injury and poisoning and Chapter X: respiratory diseases. Associated with the intervention, significant decreases in the numbers of presentations per 1 000 RACF beds were identified among patients diagnosed with Chapter XI: digestive diseases [rate ratio(95%CI): 0.09(0.04, 0.22); P<0.0001] and Chapter XXI: factors influencing health status and contact with health services [rate ratio(95%CI): 0.22(0.07, 0.66); P=0.007].CONCLUSION: The Hi NH program may reduce the incidence of RACF residents visiting EDs for diagnoses of Chapter XI and Chapter XXI.
文摘The present study developed and tested a method to evaluate the location of aged care facilities from the viewpoint of whether they are equitably located for users,using the improved Median Share Ratio(MSR).By evaluating the current location of aged care facilities,it is possible to extract the districts which are short of facilities.The evaluation method was applied to Chofu and Kiyose Cities in Tokyo Metropolis,Japan,and the evaluation result of weighting and that of not weighting by elderly population were compared and discussed.Consequently,adopting the evaluation method with weighting by elderly population,it is possible to adequately examine the districts where new aged care facilities should be constructed.From this evidence,it is significant to evaluate the location of aged care facilities,using the improved MSR with weighting by elderly population in the study.
文摘Objective:Population ageing in China is a significant challenge for the Chinese government,the society and Chinese people.The dramatic process of population ageing together with social and economic diversity in China has created issues in the availability,equality and sustainability of social and financial support for older people.The aims of this review are to identify the social and economic challenges to the traditional caregiving system in China,and to examine possible solutions to improve the care of older people in China using the framework of ageing in place.Methods:Electronic literature searches were conducted in May and June 2013 using PubMed,CNKI,and MEDLINE.Statistical data and reports were retrieved from the United Nations,the World Health Organisation,the World Bank and National Bureau of Statistics of China.Government policy documents were found through government websites and formal publications.Results:Family-centred care for older people in China is recognised as a cultural tradition in the Chinese community.However,driven by large-scale social,political and economic changes,this model of caring for older people has dynamically changed over the last 50 years.Traditionally the family has been the most important source of social support for older people followed by neighbour support and support from friends.Today family obligations of caring are still centred in a cultural and practical context;however,support from family and children has weakened incrementally.Community-based aged services are absent in most areas,while older people and their families have to pay out-of-pocket expenses for non-residential services.There is a severe shortage of aged care or nursing home resources in China and those that exist are of low quality and expensive.The staff who work in these facilities rarely have any formal training in aged care.In addition,a market approach to the funding of residential aged care has the potential to create a moral hazard due to the poor regulatory control of aged care in China.While the building of residential aged care homes is seen as the solution to the care of older people in China,older people prefer to age in their own homes and expect the restoration of the family care tradition as well as more government support for them to“age in place”.This approach has the potential to be more cost effective than expensive aged care facilities.Conclusion:Given older people’s preferences,ageing in place,with the provision of community services and family support,potentially provides a fair and financially viable approach to promote healthy ageing and supportive care in China.Further studies are required to identify 1)how ageing in place can be supported by a national strategy,2)the financial arrangements required to fund such an approach,and 3)how to train high quality community-based professionals in both rural and urban areas to support the care of older people.
文摘This paper presents a method that combines visibility graph and isovist analyses to investigate the spatia[ and social properties of architectural plans for aged care facilities. The potential of the combined method is examined by measuring the properties of three sets of plans for residential aged care facilities. The first set is a pair of hypothetical, idealized plans, which allegedly reflect the ＂best practice＂ in the industry. The second set comprises a pair of plans for recent Australian designs, and the third set is a pair of plans for South Korean facilities. Results of the computational anatysis of these six plans suggest that social and cultural factors may shape the design of aged care settings and partially explain their international differences. The application of this methodological approach contributes to the understanding of the relation- ship between spaces and their cultural and social properties in the design of aged care facitities.
