Les soins de longue durée aux personnes âgées: Choix d'un système clinico-administratif dans le contexte d'un réseau de soins intégrés

Abstract

For the past 10 years, in long-term care systems, we have witnessed the accelerated deployment of casemix management systems. A casemix is formed by clusters, defined by individual characteristics that explain similar resource use. However, certain questions regarding the development of these systems must be raised. Moreover, none of these systems was developed in the context of an integrated care organization that can track the progress of a dependent elderly person through every kind of care arrangement available—from own home, through intermediate facility, to long-term care institution. This article emphasizes the necessity of being well informed about the features of existing systems, in order to choose or develop the system that best answers the goals of a particular health care system. Finally, it underlines important elements that should be considered in each step of the development of a casemix system in this context.

The OptimaMed intervention to reduce medication burden in nursing home residents with severe dementia: Results from a pragmatic, controlled study

“…Also, consistent with their mission to care for people with complex needs, NH admission requires an important loss of autonomy as measured by the iso-FAMS score (usually above 11 on a scale of 1 to 14). [35] The scores of this assessment algorithm provide a numerical autonomy pro le classi cation based on the FAMS tool,[36] which itself is based on the WHO's classi cation of impairments, disabilities and handicaps. [37] It measures 29 functions of 5 domains: basic activities of daily living, instrumental activities of daily living, mobility, communication, and mental functions.…”