The transition from institutional to community care for vulnerable people has been shaping the welfare system in Europe over the last decades. For the period of 2014-20 deinstitutionalization became one of the highlighted priorities of the European Commission in order to promote reforms in disability and mental health care in the convergence regions, too. Between 2007 and 2013, Estonia as many other Eastern European countries has implemented the first wave of deinstitutionalization and during the new EU budget period a second wave will be occurred in order to continue and hopefully complete the transition. In this study, we try to give an overview on the experiences of different European countries highlighting good practices and possible pitfalls. This study has been conducted at the request of the Estonian Ministry of Social Affairs.
A case study and method development research of online simulation gaming to enhance youth care knowlegde exchange. Youth care professionals affirm that the application used has enough relevance as an additional tool for knowledge construction about complex cases. They state that the usability of the application is suitable, however some remarks are given to adapt the virtual environment to the special needs of youth care knowledge exchange. The method of online simulation gaming appears to be useful to improve network competences and to explore the hidden professional capacities of the participant as to the construction of situational cognition, discourse participation and the accountability of intervention choices.
BackgroundPreference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey—Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating interventions in geriatric care as it combines multiple outcomes relevant to older persons in a single metric. The objective of this study was to validate TOPICS-CEP across different study settings (general population, primary care and hospital).MethodsData were extracted from TOPICS Minimum Dataset (MDS), a pooled public-access national database with information on older persons throughout the Netherlands. Data of 17,603 older persons were used. Meta-correlations were performed between TOPICS-CEP indexed scores, EuroQol5-D utility scores and Cantril’s ladder life satisfaction scores. Mixed linear regression analyses were performed to compare TOPICS-CEP indexed scores between known groups, e.g. persons with versus without depression.ResultsIn the complete sample and when stratified by study setting TOPICS-CEP and Cantril’s ladder were moderately correlated, whereas TOPICS-CEP and EQ-5D were highly correlated. Higher mean TOPICS-CEP scores were found in persons who were: married, lived independently and had an education at university level. Moreover, higher mean TOPICS-CEP scores were found in persons without dementia, depression, and dizziness with falls, respectively. Similar results were found when stratified by subgroup.ConclusionThis study supports that TOPICS-CEP is a robust measure which can potentially be used in broad settings to identify the effect of intervention or of prevention in elderly care.
