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Conclusion The programme theory described here provides a framework for understanding how CGA could be effective in care homes. It will be of use to teams developing, implementing or auditing CGA in care homes. All three components are required to make CGA work—this may explain why attempts to implement CGA by interventions focused solely on assessment or care planning have failed in some long-term care settings. 
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The RUG-III case-mix system is a method of grouping patients in long-term and post-acute care settings. RUG-III groups patients by relative per diem resourc
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| van Solm, PhD Journal of Emergency Management
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Frailty in older adults is a condition characterised by a loss or reduction in physiological reserve resulting in increased clinical vulnerability. However, evidence suggests that frailty may be modifiable, and identifying frail older people could help better target specific health care interventions and services.
Servicio de Geriatría's insight:
El indice fragilidad desarrollado a partir del instrumento interRAI Atención Domiciliaria predice mortalidad e institucionalización permitiendo identificar grupos de riesgo y procurar intervenciones específicas en estos grupos.
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To assess the reliability, relevance of the French version of InterRAI PC and test
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Gabrielle Stent, interRAI educator in New Zealand, talks about how the New Zealand interRAI software can be used as a patient management system. This is a pr...
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Homepage of the World InterRAI Conference organized by KU Leuven
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El estudio tiene como objetivo identificar usuarios de programas detención domiciliaria con deterioro funcional y potencial de mejora y por lo tanto aquellos en que se tienen que priorizar objetivos de recuperación funcional.
Servicio de Geriatría's insight:
El estudio demuestra que "el potencial subjetivo de mejora y la duración del declive funcional" como mejores predictores de ganancia funcional. Así mismo confirmó el beneficio de los programas de atención domiciliaria en la recuperación funcional y se aprecia que los porcentajes de mejora aumentan con la edad en el algoritmo de recuperación funcional.
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This paper describes an integrated series of functional, clinical, and discharge post-acute care (PAC) quality indicators (QIs) and an examination of the distribution of the QIs in skilled nursing facilities (SNF) across the US. The indicators use items available in interRAI based instruments. With increasing use of interRAI assessment tools from which the PAC QIs can be derived (the MDS 3.0, MDS 2.0, LTCF, and interRAI-PAC-Rehab), there is hope that the PAC QIs in this paper have the potential of at least informing the movement toward international standards or benchmarks.
Servicio de Geriatría's insight:
Interesante por el abordaje metodológico empleado a la hora de valorar la mejora funcional y por el impacto potencial de estos IQ en benchmark internacional. Definen 5 IQ funcionales, siguiendo el constructo de Katz se subdividen las ABVD de perdida precoz, media y tardía, deambulación y el ADL Long Form (este último define mejora como la ganancia en dos puntos de su puntuación total.
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Underpinning standards for developing comprehensive care in hospital is the need to identify, early in the admission process, functional and psychosocial issues which affect patient outcomes.
Gray, L et al Health Services Insights Dec. 2018
Servicio de Geriatría's insight:
El artículo presenta resultados de fiabilidad interobservador en 130 valoraciones duales. Tiempo de pasación de 15 min por termino medio y reducción a un instrumento de 56 items para la valoración estandarizada de ingreso y de 30 items al alta. El instrumento ofrece un sistema homogéneo de valoración de necesidades funcionales y psicosociales del paciente adulto hospitalizado.
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Currently, there are no formalized measures for the quality of home based palliative care in Ontario. This study developed a set of potential quality indicators for seriously ill home care clients using a standardized assessment.
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