Abstract Objective: To describe changes in the health service delivery process experienced by professionals, patients and informal caregivers during implementation of a national programme to improve quality of care of geriatric rehabilitation by improving integration of health service delivery processes. Study setting: Sixteen skilled nursing facilities. Study design: Prospective study, comparing three consecutive cohorts. Data collection: Professionals (elderly care physicians, physiotherapists and nursing staff) rated four domains of health service delivery at admission and at discharge of 1075 patients. In addition, these patients [median age 79 (Interquartile range 71–85) years, 63% females] and their informal caregivers rated their experiences on these domains 4 weeks after discharge. Principal findings: During the three consecutive cohorts, professionals reported improvement on the domain team cooperation, including assessment for intensive treatment and information transfer among professionals. Fewer improvements were reported within the domains alignment with patients’ needs, care coordination and care quality. Between the cohorts, according to patients (n = 521) and informal caregivers (n = 319) there were no changes in the four domains of health service delivery. Conclusion: This national programme resulted in small improvements in team cooperation as reported by the professionals. No effects were found on patients’ and informal caregivers’ perceptions of health service delivery.
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Background: Geriatric rehabilitation positively influences health outcomes in older adults after acute events. Integrating mobile health (mHealth) technologies with geriatric rehabilitation may further improve outcomes by increasing therapy time and independence, potentially enhancing functional recovery. Previous reviews have highlighted positive outcomes but also the need for further investigation of populations receiving geriatric rehabilitation. Objective: Our main objective was to assess the effects of mHealth applications on the health status of older adults after acute events. A secondary objective was to examine the structure and process elements reported in these studies. Methods: Systematic review, including studies from 2010 to January 2024. Studies were eligible if they involved older adults’ post-acute care and used mHealth interventions, measured health outcomes and compared intervention and control groups. The adjusted Donabedian Structure-Process-Outcome (SPO) framework was used to present reported intervention processes and structures. Results: After initial and secondary screenings of the literature, a total of nine studies reporting 26 health outcomes were included. mHealth interventions ranged from mobile apps to wearables to web platforms. While most outcomes showed improvement in both the intervention and control groups, a majority favored the intervention groups. Reporting of integration into daily practice was minimal. Conclusion: While mHealth shows positive effects on health status in geriatric rehabilitation, the variability in outcomes and methodologies among studies, along with a generally high risk of bias, suggest cautious interpretation. Standardized measurement approaches and co-created interventions are needed to enhance successful uptake into blended care and keep geriatric rehabilitation accessible and affordable.
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Key summary points Aim To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Findings This guidance addresses general requirements for post-acute COVID-19 geriatric rehabilitation and critical aspects for quality assurance during the COVID-19 pandemic. Furthermore, the guidance describes relevant care processes and procedures divided in five topics: patient selection; admission; treatment; discharge; and follow-up and monitoring. Message This guidance is designed to provide support to care professionals involved in the geriatric rehabilitation treatment of post-acute COVID-19 patients.
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