Table 1 Summary of included studies
From: Measured outcomes of chronic care programs for older adults: a systematic review
[Study reference #] | Study design | Level of analysis | Type of measure | |||
|---|---|---|---|---|---|---|
Setting | Health System | Individual | System impact | Quality of Care | Individual outcome | |
n = number of outcomes measured | ||||||
[18] Post-discharge from hospital | Longitudinal, Randomized trial | N/A | 24 patient | Emergency Department visits | Quality of medical management | Cognitive function |
1 caregiver | Hospitalizations Nursing home admission | Patient involvement in decision making | Physical function | |||
Access to care | Quality of Life | |||||
Satisfaction | ADL function | |||||
Completion of advanced directives | IADL function | |||||
Medications | ||||||
Blood pressure | ||||||
Depression and anxiety | ||||||
Falls | ||||||
Nutrition | ||||||
Pain | ||||||
Exercise | ||||||
Smoking | ||||||
Caregiver strain* | ||||||
Incontinence | ||||||
Knowledge of personal health risk factors | ||||||
Medication organization | ||||||
Disease management knowledge | ||||||
[22] Community | Longitudinal, Randomized trial | N/A | 5 patient | N/A | Symptom management | Quality of life/death |
Relationships | ||||||
Decision making/care planning/continuity/communication | ||||||
Depression and anxiety | ||||||
[19] Integrated Services for Frail Elders (SIPA), Community Primary Hospital care | Randomized control trial | N/A | 15 patient | Total healthcare costs | N/A | N/A |
Cost for community services | ||||||
Cost for institutional services | ||||||
Utilization of home care | ||||||
Utilization of GP services | ||||||
Number nursing home hours | ||||||
Utilization of specialist care | ||||||
Prescribed drugs | ||||||
Number of days in acute care | ||||||
Number of days in chronic care | ||||||
Number of days in LTC facility | ||||||
Number of hours of social services | ||||||
Number of hours at ED | ||||||
ED visits | ||||||
Hospitalizations | ||||||
[16] Primary care practices | Cluster-randomized controlled trial | 1 | 10 patient | Hospitalizations | Perceived quality of care | Caregiver depression* |
4 caregiver | Hospital days | Caregiver perceived quality of care* | Caregiver strain* | |||
2 provider | Skilled nursing facility admissions | Satisfaction with care^ | ||||
Skilled nursing facility days | Satisfaction with knowledge^ | |||||
ED visits | Team’s problem-solving performance# | |||||
GP visits | ||||||
Specialist visits | ||||||
Home healthcare | ||||||
Healthcare costs | ||||||
Productivity loss* | ||||||
[24] Primary care - capitated plan | Pilot implementation and evaluation | N/A | 1 patient | N/A | Primary Care Assessment Survey (included communication, interpersonal treatment, knowledge of patient, integration of care, and trust in physician) | N/A |
[23] Geriatric Ambulatory Practice | Longitudinal, Pre-post | N/A | 7 patient | N/A | HBA1c test in last 9 months | HbA1c levels |
Foot examination done | LDL cholesterol level | |||||
Lipid panel in last 9 months | Blood pressure | |||||
LDL cholesterol test | ||||||
[14] Community | Mixed-methods (provider interviews and patient surveys) | 1 | 3 patient | N/A | N/A | Physical quality of life |
Physical activity | ||||||
Current smoking | ||||||
DMP impact on healthier behavior# | ||||||
[21] Hospital, community, Rehab centre, GP offices | Quality Improvement Project and evaluation | N/A | 6 patient | N/A | GP opinion of collaboration^ | Nutritional status |
1 provider | Patient satisfaction | Clinical tests | ||||
Physical function | ||||||
Patient self-assessment of function | ||||||
Quality of life | ||||||
[17] Primary care practices | Cluster randomized trial | 1 | 10 patient | Acute hospital admissions | Patient reported client centred care | Quality of Life |
2 carer | ||||||
Costs (direct and indirect costs)# | Coordination of care from patient perspective | Health-related Quality of Life | ||||
Independence in ADL | ||||||
Psychological Wellbeing | ||||||
Social functioning | ||||||
Self-reported health | ||||||
Care needs | ||||||
Caregiver quality of life* | ||||||
Caregiver self-rated burden of care* | ||||||
[20] Primary care - managed care plan | Longitudinal, Quasi experimental | 3 | 2 patient | Health service resource use | N/A | N/A |
Cost of care | ||||||
Number of hospitalizations# | ||||||
Hospital bed days# | ||||||
Number of ED visits# | ||||||
[13] Community | Randomized control trial | N/A | 12 patient | Cost analysis | Perceived chronic illness care | Complexity of care needs |
2 caregiver | Service use | Self-management knowledge and behavior | Frailty | |||
1 provider | ||||||
Impact of interventions | Health status | |||||
Provider perceived chronic illness care^ | Self-management ability | |||||
Caregiver burden* | ||||||
Well-being | ||||||
Activities of daily living (ADL) | ||||||
Quality of life/* | ||||||
[12] General Practice | Longitudinal, Quasi experimental (13 intervention practices, 11 control) | N/A | 7 patient | Healthcare utilization | Care satisfaction | Health-related quality of life |
Nursing home admission | Disability in ADL and IADL | |||||
Attitude towards aging | ||||||
Mortality | ||||||
[15] Senior Health and Wellness Centre | Continuous quality improvement | 3 | 7 patient | Service utilization# | Patient satisfaction | Clinical |
Diabetics with HbA1c less than 7 | Function | |||||
Chronic pain improvement | ||||||
Employee satisfaction# | ||||||
Pts with >4 meds receiving geriatric pharmacist review | ||||||
Staff turnover rates# | ||||||
Teamness# | ||||||
[11] Senior Health and Wellness Centre | Longitudinal panel | N/A | 2 patient | N/A | N/A | Physical function |
Health-related quality of life | ||||||