Integration of care systems in Portugal: anatomy of recent reforms

Szczygieł, Nina; Redondo, Patrícia

doi:10.5334/ijic.989

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…According to our research, middle-aged and older Portuguese who are providing this type of care face important challenges in terms of depressive symptoms. The existence of modest LTC services [ 29 ] and the unequal distribution of mental health services in Portugal [ 45 ] may jeopardize the mental health of Portuguese co-residential caregivers. In this sense, it is crucial to reconfigure and consolidate Portuguese public social and health care services to promote greater equity in access to health and social services.…”

Section: Discussionmentioning

confidence: 99%

Health impact of providing informal care in Portugal

2020

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Background Middle-aged and older adults play an important role in the provision of informal support, however, the impact on the health of those individuals who provide informal care is unclear. The main objectives of this study are: (1) to assess the prevalence of co-residential caregiving provided by individuals aged 50+; (2) to analyze differences between the group of Portuguese co-residential caregivers and the group of Portuguese non-caregivers; (3) to examine the longitudinal effect of providing informal care on the health of co-residential informal caregivers in Portugal. Methods Data from wave 4 and wave 6 of the Survey of Health Ageing and Retirement in Europe (SHARE) were used. A linear mixed model and a generalized mixed model were used to analyze the longitudinal effect of providing informal care on the health (physical health and depressive symptoms) of Portuguese individuals aged 50 + . Results In both SHARE waves analyzed, Portugal had the highest percentage of co-residential caregivers aged 50+. At baseline, the Portuguese co-residential caregiver population, compared to non-caregivers, has a lower percentage of employed individuals (14.9% compared to 25.7%) and a higher percentage of individuals with four or more depressive symptoms (56.4% compared to 35.5%). The caregivers also have a lower quality of life (CASP-12) (30.93 compared to 32.59). Marginal differences in educational levels between the caregiver and non-caregiver groups were also found, with co-residential caregivers having lower levels of education (72.3% have ISCED 0–2 compared to 64.7%), lower levels of cognitive function (− 2.321 compared to − 1.784), lower levels of physical health (− 0.180 compared to − 0.076) and lower engagement in moderate or vigorous physical activity (14.9% compared to 21.5%). Longitudinal models reveal that providing care within the household is not associated with physical health (b = 0.048; se = 0.035; p = 0.167), but is associated with depressive symptoms (OR = 1.609; 95% CI = 1.141–2.271; p = < 0.010). Conclusions Portugal has the highest percentage of co-residential caregivers aged 50+. In that country, providing informal care to a household member is associated with depressive symptoms. Portuguese policymakers should therefore promote programs to prevent and alleviate the depressive symptoms experienced by individuals aged 50+, who provide co-residential care.

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Section: Discussionmentioning

confidence: 99%

Health impact of providing informal care in Portugal

2020

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“…In Portugal, stroke patients discharged from acute care hospitals are faced with a number of rehabilitation possibilities. 12 Since the establishment of the National Network of Long-Term Integrated Care in 2006, they could be discharged to a convalescence unit where they would undergo up to one month of intensive, inpatient rehabilitation, after which a new assessment of their condition and further needs would be made. However, by the time this study was carried out, many patients were being discharged directly home, with variable access to further ambulatory rehabilitation performed either at the hospital or other public institution or at private clinics.…”

Section: Introductionmentioning

confidence: 99%

Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial

Santana

Rente²,

Neves³

et al. 2016

Clin Rehabil

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Objective:To evaluate an early home-supported discharge service for stroke patients.Design:We carried out a prospective, randomised, open-label, blinded-endpoint trial (allocation ratio of 1:1) with patients assigned to either an early home-supported discharge service or usual care.Setting:The study was undertaken in Aveiro, Portugal, between April 2009 and April 2013.Subjects:We included stroke patients aged 25–85 years admitted to the stroke unit with an initial Functional Independence Measure of up to 100, who gave informed consent.Interventions:Patients in the early home-supported discharge group began their rehabilitation intervention in the stroke unit and the early home-supported discharge team worked with them at home for a maximum of one month. Patients in the control group received usual services.Main measures:The primary outcome measure was the Functional Independence Measure at six months after stroke.Results:We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17) measured at baseline; and between the early home-supported discharge (107 ±20) and the control groups (107 ±25) measured at six months. The number of individuals with a low Functional Independence Measure score (<60) in the early home-supported discharge group compared with the control group was higher at admission (34/95 vs. 26/95) and lower at follow-up (2/74 vs. 5/78).Conclusions:It was feasible to implement early home-supported discharge procedures in a Southern European setting, but we have not shown convincing differences in disability at six months.

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“…Nonetheless, this trend has not been accompanied by clear policy measures that consider the needs of the elderly population. 6 Although the achievement of increased longevity is a result of improvements in health and medical care services, those with very advanced ages are likely to have more frailty conditions and disabilities, requiring more medical services and social support. 7 The World Health Organization defines disability as "an umbrella term, covering impairments, activity limitations, and participation restrictions" in one or more functional areas (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…3 The number of oldest old suffered a great increase over the last decades, and according to the most recent projections life expectancy is expected to continue to increase, and in 2060 it will be 84.21 years for men and 89.88 years for women. 4 Life expectancy Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com Brandão D, et al Functional, sensorial, mobility and communication difficulties in the portuguese oldest old (80+), Acta Med Port 2017 Jun;30 (6): [463][464][465][466][467][468][469][470][471] at age 80 also suffered a positive tendency: in 1980 -1985 it was 6.5 years, currently it is projected to rise to 11.5 years in 2045 -2050, according to a report of the United Nations on the profiles of ageing. 5 These improvements on life expectancy are one of the findings that best reflect the positive change in health indicators that have occurred over last decades in Portugal.…”

Section: Introductionmentioning

confidence: 99%

Functional, Sensorial, Mobility and Communication Difficulties in the Portuguese Oldest Old (80+)

2017

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RESUMOIntrodução: O envelhecimento da população é evidente na maioria dos países desenvolvidos, e o grupo dos muito idosos é um dos segmentos da população com mais rápido crescimento. O objetivo deste estudo é analisar as características sociodemográficas e de saúde dos muito idosos portugueses, usando uma abordagem baseada nos dados dos censos populacionais. Material e Métodos: Foi conduzido um estudo descritivo considerando todos os residentes com 80 ou mais anos à data dos Censos 2011 (n = 532 219). Os dados dos questionários dos Censos acerca das características sociodemográficas, funções sensoriais (visão, audição), estado funcional (andar/subir degraus, tomar banho/vestir-se sozinho), cognição (memória/concentração) e comunicação (compreender os outros/fazer-se entender) foram analisados. Resultados: Os resultados revelaram que a maioria dos muito idosos são mulheres (64,5%), viúvos (53,9%), analfabetos (46,1%) e vivem em contexto domiciliar (88,8%). Andar/subir degraus (57,1%), visão (39,1%) e audição (35,1%) foram as dimensões onde os muito idosos apresentavam maiores constrangimentos. Em paralelo, compreender os outros/fazer-se entender (25,9%) e memória/ concentração (34,4%) foram as dimensões com percentagens mais baixas de dificuldade. Foram encontradas diferenças significativas entre a população octogenária/nonagenária e a população centenária para a visão, andar/subir escadas, e tomar banho/vestir-se sozinho, com os centenários a apresentarem uma maior percentagem de dificuldade. Discussão: Os muito idosos portugueses apresentam dificuldades significativas nas atividades de vida diária, contudo, as capacidades cognitivas e de comunicação parecem ser comummente mantidas. Em conjunto, estes resultados sugerem a necessidade de assistência funcional, mas que pode ser, em última instância, gerida pelo próprio idoso. Conclusão: Considerando as diferenças observadas entre os centenários e os idosos mais jovens, devem ser equacionadas intervenções capazes de responder às necessidades potencialmente específicas de cada grupo. Palavras-chave: Actividades da Vida Diária; Avaliação da Deficiência; Censo; Demografia; Idoso, 80 anos e mais; Idoso Fragilizado; Portugal ABSTRACT Introduction:The ageing of populations is evident in most developed countries, and the oldest old group is one of the segments with the fastest growing. The aim of this paper is to examine sociodemographic and health related characteristics of the portuguese oldest old, using a census-based approach. Material and Methods:A descriptive study considering all residents aged 80 years and older at the time of the 2011 Census (n = 532 219) was conducted. Information on sociodemographic characteristics, sensory functions (seeing, hearing), functional status (walking/climbing stairs, bathing/dressing alone), cognition (memory/concentration), and communication (understanding others/being understood) as assessed by the Portuguese census official questionnaires were analyzed. Results: Findings revealed that most of the oldest old are women (64.5%), w...

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Integration of care systems in Portugal: anatomy of recent reforms

Cited by 13 publications

References 26 publications

Health impact of providing informal care in Portugal

Health impact of providing informal care in Portugal

Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial

Functional, Sensorial, Mobility and Communication Difficulties in the Portuguese Oldest Old (80+)

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