Catheter replacement structure in home medical care settings and regional characteristics in Tokyo and three adjoining prefectures

Background Although more than seven million older adults struggle or are unable to leave their homes independently, only a small minority access home‐based primary care (HBPC). Despite substantial growth of HBPC, fueled by growing evidence supporting positive patient outcomes and cost savings, the population remains dramatically underserved and many evidence gaps still exist around scope of practice and key issues in care delivery and quality. Understanding the current state of the field is critical to the delivery of high‐quality home‐based care. Methods We conducted a systematic search of the peer‐reviewed literature on HBPC, published between January 2010 and January 2020, using Medline, CINAHL, Embase, Web of Science, and Scopus online libraries. All studies were evaluated by two members of the research team, and key findings were extracted. Results The initial search yielded 1730 unique studies for screening. Of these initial results, 1322 were deemed not relevant to this review. Of the 408 studies deemed potentially relevant, 79 were included in the study. Researchers identified five overarching themes: the provision of HBPC, the composition of care teams, HBPC outcomes, the role of telehealth, and emergency preparedness efforts. Conclusion The need and desire for growth of HBPC has been highlighted by the recent COVID‐19 pandemic. Current research on HBPC finds a diverse scope of practice, successful use of interdisciplinary teams, positive outcomes, and increasing interest in telehealth with many areas ripe for further research.

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“…Twenty‐nine articles examined the scope of HBPC care delivery practice or evaluated HBPC care delivery models 4,13–34 …”

Section: Resultsmentioning

confidence: 99%

Home‐based primary care: A systematic review of the literature, 2010–2020

Zimbroff

Ornstein²,

Sheehan

2021

J American Geriatrics Society

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“…The questionnaire contained questions intended for two studies; one is the present study and the other a study for the structure of catheter replacement services in home medical settings and the regional characteristics in the same region covered in the present study (Kimura et al 2016), and in total, contained 103 questions (16 pages) for physicians and 105 questions (16 pages) for nurses. Both physicians and nurses were asked to respond to items covering replacement of gastrostomy tubes, nasogastric tubes, tracheal cannulas, and urethral catheters for male and female patients (Center for Home Care Medicine, Faculty of Medicine, The University of Tokyo 2015).…”

Section: Questionnairesmentioning

confidence: 99%

“…Both physicians and nurses were asked to respond to items covering replacement of gastrostomy tubes, nasogastric tubes, tracheal cannulas, and urethral catheters for male and female patients (Center for Home Care Medicine, Faculty of Medicine, The University of Tokyo 2015). The questionnaire items were selected after discussion based on previous studies (All Japan Hospital Association 2011; Institute for Health Economics and Policy 2011; Ministry of Health, Labour and Welfare of Japan 2013a, b; Kimura et al 2016).…”

Section: Questionnairesmentioning

confidence: 99%

Cooperation between Single-Handed and Group Practices Ensures the Replacement of Gastrostomy Tubes and Tracheal Cannulas in Home Medical Care Settings

Kimura

Yoshie

Tsuchiya

et al. 2017

Tohoku J. Exp. Med.

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In Japan, patients who require home medical care are increasing especially in the elderly. In home medical care settings, devices such as gastrostomy tubes, tracheal cannulas, and urethral catheters are usually replaced by visiting physicians or nurses. However, device replacement services are not always available in Japan. Unless device replacement services are sufficiently provided to patients at home, patients have to suffer various disadvantages, including a forced visit to a hospital for device replacement despite inability to walk. We therefore investigated background factors of clinics and nursing stations providing home-care visits using a cross-sectional postal survey from August to September 2013. We targeted physicians from 5,828 clinics providing home medical care and nurses from 1,798 home-visit nursing stations across six prefectures (Tokyo, Kanagawa, Saitama, Chiba, Miyagi and Iwate). Responses were received from 933 clinics (16.5%) and 552 stations (31.3%). We analyzed the responses using multivariable logistic regression with two models. "Model 1" mainly included the number of full-time staff and the availability of a 24-hour care service system, and "Model 2" mainly included the number of clinics, the number of home-visit nursing stations, and the ratio of the population aged ≥ 65 years to study the influence of medical resources. We thus found that clinic staff numbers and 24-hour care availability were associated with physicians' replacement of gastrostomy tubes and tracheal cannulas (p < 0.001 for each). In conclusion, single-handed and group practices need to cooperate to ensure the replacement of these devices in home medical care settings.

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ポストコロナ時代における在宅医療の展望

Kimura

2023

J. Jpn. Soc. Intern. Med

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Catheter replacement structure in home medical care settings and regional characteristics in Tokyo and three adjoining prefectures

Abstract: In home medical care settings, urethral catheters for male patients are replaced by nurses in regions where physician resources are limited. Geriatr Gerontol Int 2017; 17: 628-636.

Cited by 3 publications

References 9 publications

Home‐based primary care: A systematic review of the literature, 2010–2020

Home‐based primary care: A systematic review of the literature, 2010–2020

Cooperation between Single-Handed and Group Practices Ensures the Replacement of Gastrostomy Tubes and Tracheal Cannulas in Home Medical Care Settings

ポストコロナ時代における在宅医療の展望

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