Frailty Screening: Inflammatory Markers Assessment and Identification of Adverse Health Factors in Hospitalized Older Adults.

BACKGROUND AND PURPOSE: The detection of older individuals who are most vulnerable to adverse health effects (AHE) may be useful for practitioners in managing health care resources. The purpose of this study was to analyze the prevalence and identify AHE after hospital discharge (HD). METHODS: This cohort study included 135 hospitalized older individuals. Fragility was assessed by changes in the plasma concentrations of C-reactive protein and / or leukocytes. RESULTS: Fragile individuals had a higher risk of rehospitalization, consumption of drugs, functional impairment and mortality within 30 days post-HD, and higher risk of functional disability at 180 days post-HD. CONCLUSION: More than one-third of hospitalized older individuals are fragile and require more attention in the first 30 days because of the associated AHE.

Home care organization with the Better at Home Program. / Organização da atenção domiciliar com o Programa Melhor em Casa.

OBJECTIVE To understand the home healthcare organization modes in the context of healthcare delivered by the municipalities that have joined a Program entitled Better at Home. METHODS A multicenter qualitative study. Data collection performed in 12 municipalities, from February of 2014 to July of 2015, through semi-structured interviews with 12 Homecare Services coordinators and six managers. Content analysis was used as a method of data processing. RESULTS Two categories of analysis have emerged: Supply management regulated by political and administrative demands, previous experiences and local health profile; and Modes of organization mediated by users' needs. CONCLUSION It is concluded that the significant progress observed in homecare organization modes stems from the integration of management and care aspects. It is highlighted that this substitutive care modality may enhance the effectiveness of the services, reducing fragmentation and solvability of the health needs.

Organização da atenção domiciliar com o Programa Melhor em Casa / Organización de la atención a domicilio con el Programa Mejor en Casa / Home care organization with the Better at Home Program

Resumo OBJETIVO Compreender os modos de organização da Atenção Domiciliar no contexto da atenção à saúde ofertada por municípios que aderiram ao Programa Melhor em Casa, no Estado de Minas Gerais. MÉTODOS Estudo multicêntrico com abordagem qualitativa. Dados coletados em 12 municípios mineiros, entre fevereiro de 2014 e julho de 2015, por meio de entrevistas semiestruturadas, com 12 coordenadores de Serviços de Atenção Domiciliar e seis gestores. Utilizou-se a Análise de Conteúdo como método de tratamento dos dados. RESULTADOS Obtiveram-se duas categorias de análise: Organização da oferta regulada por demandas político-administrativas, experiências prévias e perfil de saúde local e Modos de organização mediados pelas necessidades dos usuários. CONCLUSÃO Depreende-se que o sucesso notado nos modos de organização da Atenção Domiciliar decorre da integração entre elementos da gestão e assistenciais. Reforça-se que esta modalidade assistencial substitutiva apresenta potencial para a efetividade dos serviços, redução da fragmentação e resolubilidade das necessidades de saúde.

Resumen OBJETIVO Comprender las maneras de organización de la atención domiciliaria en el contexto de la atención a la salud ofrecida por municipios que adherirán al Programa Mejor en Casa. MÉTODOS Estudio metacéntrico con abordaje cualitativa. Datos colectados en 12 municipios, entre febrero de 2014 y julio de 2015, por medio de entrevistas semiestructuradas, con 12 coordinadores de servicios de atención domiciliaria y seis administradores. Se utilizó el Analice de Contenido como método de tratamiento de los datos. RESULTADOS Se obtuvieron dos categorías de analice: Organización de la oferta regulada por demandas político-administrativas, experiencias previas y perfil de salud local y Maneras de organización mediadas por las necesidades de los usuarios. CONCLUSIÓN Se deprende que el suceso notado en las maneras de organización de la atención domiciliaria se sigue a la integración entre elementos de la administración y asistenciales. Se refuerza que esta modalidad asistencial substitutiva presenta potencial para la efectividad de los servicios, reducción de la fragmentación y resolución de las necesidades de salud.

Abstract OBJECTIVE To understand the home healthcare organization modes in the context of healthcare delivered by the municipalities that have joined a Program entitled Better at Home. METHODS A multicenter qualitative study. Data collection performed in 12 municipalities, from February of 2014 to July of 2015, through semi-structured interviews with 12 Homecare Services coordinators and six managers. Content analysis was used as a method of data processing. RESULTS Two categories of analysis have emerged: Supply management regulated by political and administrative demands, previous experiences and local health profile; and Modes of organization mediated by users' needs. CONCLUSION It is concluded that the significant progress observed in homecare organization modes stems from the integration of management and care aspects. It is highlighted that this substitutive care modality may enhance the effectiveness of the services, reducing fragmentation and solvability of the health needs.