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Healthcare
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Ageing and Healthcare Utilisation
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Ageing and Healthcare Utilisation

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (24 January 2024) | Viewed by 11434

Special Issue Editor

Dr. Sally Fowler-Davis

E-Mail Website
Guest Editor
Organisation in Health and Care, Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S9 3TY, UK
Interests: measurement of health outcomes; measuring the quality and impact of services

Special Issue Information

Dear Colleagues,

This Special Issue concerns ageing and the utilisation of the healthcare system based on user entitlement in different healthcare systems, focusing on the differential access to healthcare. Multimorbidity, social and economic factors and user expectations are the main considerations for the services. Targeting poorer, older and more marginalised communities to improve accessibility to the services is now recognised as an important challenge to improve health outcomes internationally.

Post-pandemic, many services now aim to re-design their workforce, and improve recruitment and retention. In the UK, an additional factor in healthcare utilisation is the ambition to achieve a net zero NHS by 2030, and thus facilitating new ways of enabling care and access for older people without increasing the carbon footprint is critical. Recent studies reporting novel complex service re-designs addressing and improving utilisation are welcome.

The submission of original articles, systematic reviews, short communications, and other article types on related topics are also welcome. All manuscripts will follow the standard journal peer-review practices, and those accepted for publication will appear in this Special Issue on ageing and the utilisation of the healthcare system. We look forward to receiving your contributions. 

Dr. Sally Fowler-Davis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Editorial

Jump to: Research, Other

5 pages, 201 KiB  
Editorial
Healthcare Utilisation—Why the Problem of Equalising Access Has Become Even Harder
by Sally Fowler Davis
Healthcare 2023, 11(17), 2430; https://doi.org/10.3390/healthcare11172430 - 30 Aug 2023
Viewed by 732
Abstract
People use healthcare services to diagnose, cure, or ameliorate disease or injury, to improve or maintain function, or to obtain information about their health status and prognosis [...] Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)

Research

Jump to: Editorial, Other

11 pages, 584 KiB  
Communication
Establishing Innovative Complex Services: Learning from the Active Together Cancer Prehabilitation and Rehabilitation Service
by Carol Keen, Gail Phillips, Michael Thelwell, Liam Humphreys, Laura Evans and Rob Copeland
Healthcare 2023, 11(23), 3007; https://doi.org/10.3390/healthcare11233007 - 21 Nov 2023
Cited by 2 | Viewed by 996
Abstract
Prehabilitation and rehabilitation will be essential services in an ageing population to support patients with cancer to live well through their life spans. Active Together is a novel evidence-based service embedded within existing healthcare pathways in an innovative collaboration between health, academic, and [...] Read more.
Prehabilitation and rehabilitation will be essential services in an ageing population to support patients with cancer to live well through their life spans. Active Together is a novel evidence-based service embedded within existing healthcare pathways in an innovative collaboration between health, academic, and charity organisations. Designed to improve outcomes for cancer patients and reduce the demand on healthcare resources, it offers physical, nutritional, and psychological prehabilitation and rehabilitation support to patients undergoing cancer treatment. The service is underpinned by behaviour change theories and an individualised and personalised approach to care, addressing the health inequalities that might come about through age, poverty, ethnicity, or culture. Meeting the challenge of delivering high-quality services across multiple stakeholders, while addressing the complexity of patient need, has required skilled leadership, flexibility, and innovation. To support patients equally, regardless of geography or demographics, future services will need to be scaled regionally and be available in locations amenable to the populations they serve. To deliver these services across wide geographic regions, involving multiple providers and complex patient pathways, will require a systems approach. This means embracing and addressing the complexity of the contexts within which these services are delivered, to ensure efficient, high-quality provision of care, while supporting staff well-being and meeting the needs of patients. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
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11 pages, 657 KiB  
Article
Understanding the Contribution of Community Organisations to Healthy Ageing and Integrated Place-Based Care: Evidence from Integrated Care Data
by Chris Dayson, Chris Damm, Jan Gilbertson, David Leather and Will Ridge
Healthcare 2023, 11(21), 2827; https://doi.org/10.3390/healthcare11212827 - 26 Oct 2023
Viewed by 946
Abstract
(1) Background. There is interest in the role community organisations can play to support healthy ageing and the integration of health and social care. This study explored the contribution community organisations can make to this goal through the Leeds (UK) Neighbourhood Networks [...] Read more.
(1) Background. There is interest in the role community organisations can play to support healthy ageing and the integration of health and social care. This study explored the contribution community organisations can make to this goal through the Leeds (UK) Neighbourhood Networks (LNNs), a novel example of community-based support. (2) Methods. An observational study of 148 LNN beneficiaries compared to the Leeds population aged 64 and over (n = 143,418) using the Leeds Data Model, and an analytical resource developed to support care planning. Measures included demographic characteristics, Electronic Frailty Index (EFI), the number of long-term health conditions (LTCs), and public health management cohort categorisation. (3) Results. LNN’s are primarily focussed on older people who are fit (44 percent) or experiencing the onset of LTCs (27 percent) and/or mild frailty (41 percent). However, they also support smaller numbers of people with moderate/severe frailty (15 percent) and five or more long-term conditions (19 percent). (4) Conclusions. Community organisations are well placed to support the ambitions of integrated care by providing support for older people with mild to moderate health and care needs. They also have the capacity to support older people with more severe needs if resourced to do so. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
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17 pages, 944 KiB  
Article
Impact of Voluntary, Community and Social Enterprise (VCSE) Organisations Working with Underserved Communities with Type 2 Diabetes Mellitus in England
by Lucie Nield, Sadiq Bhanbhro, Helen Steers, Anna Young and Sally Fowler Davis
Healthcare 2023, 11(18), 2499; https://doi.org/10.3390/healthcare11182499 - 08 Sep 2023
Viewed by 1007
Abstract
The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those [...] Read more.
The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those living with type 2 diabetes mellitus (T2DM) and to develop a theory of change (TofC) through understanding the impact of VCSE organisations on diabetes management. An appreciative inquiry (AI) was carried out and co-delivered using qualitative interviews and an embedded analysis with VCSE partners. A voluntary service coordinated seven VCSE organisations who assisted with recruiting their service users and undertook interviews to identify the impact of existing activities and programmes. People living with T2DM were interviewed about services. Themes were as follows: (a) individual and group activities; (b) trusted services and relationships across the community; (c) long-term engagement; (d) sociocultural context of diet and nutritional choices; (e) experience of adaptation; and (f) culturally appropriate advice and independent VCSE organisations. The structured educational approach (DESMOND) for T2DM was accessed variably, despite these services being recommended by NICE guidelines as a standard intervention. The VCSE offered continuity and culturally appropriate services to more marginalised groups. This evaluation highlights the importance of targeted engagement with underserved communities, particularly where primary care services are more limited. The TofC is a unique insight into the impact of VCSE services, offering bespoke support to manage T2DM, suggesting areas for improvements in capacity and offering the capability to sustain the VCSE sector as an essential element of the T2DM care pathway in England. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
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14 pages, 290 KiB  
Article
Drug Utilisation Review among Geriatric Patients with Noncommunicable Diseases in a Primary Care Setting in Malaysia
by Priya Manirajan and Palanisamy Sivanandy
Healthcare 2023, 11(12), 1665; https://doi.org/10.3390/healthcare11121665 - 06 Jun 2023
Cited by 3 | Viewed by 1585
Abstract
A prospective cross-sectional study was conducted to analyse the drugs prescribed to the elderly population with noncommunicable diseases and to determine the polypharmacy at a primary care clinic in Negeri Sembilan, Malaysia. The study was conducted for 6 months at the primary care [...] Read more.
A prospective cross-sectional study was conducted to analyse the drugs prescribed to the elderly population with noncommunicable diseases and to determine the polypharmacy at a primary care clinic in Negeri Sembilan, Malaysia. The study was conducted for 6 months at the primary care clinic of Gemas. Geriatric patients above the age of 65 and diagnosed with noncommunicable diseases were included upon providing written informed consent. The majority of the geriatric patients were between 65 and 69 years (mean: 69.72 ± 2.85) and prescribed 4 or more medications (mean: 5.18 ± 0.64, p = 0.007). More than 95% (n = 295) of the geriatrics were found to have multimorbidity, in which around 45% (n = 139) had type-2 diabetes together with hypertension and dyslipidaemia. Combination therapy was prescribed to more than 97% (n = 302) of the elderly, whereas cardiovascular and endocrine medications were the most commonly prescribed. Ten prescriptions were found to have drug-related problems, prescribing cascade (80%), lack of medicine optimisation (10%), and inappropriate prescription (10%). In this study, the majority of the elderly had multimorbidity; polypharmacy was commonly seen among geriatric patients. Polypharmacy is the biggest threat to the elderly population, as it increases the chances of falls and fall-related injuries. Medicine optimisation and deprescribing will reduce the chances of drug-related problems and morbidity and mortality associated with polypharmacy and over-consumption of medications. Hence, the study recommends the health fraternity look for medication optimisation and deprescribing to reduce the future complications associated with polypharmacy. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
9 pages, 416 KiB  
Article
The Impact of Caregiving on Successful Ageing of Informal Carers: A Qualitative Study among Respiratory Patients’ Caregivers
by Snježana Benko Meštrović, Iva Šklempe Kokić, Adriano Friganović, Sabina Krupa, Dijana Babić, Erika Zelko and Dušan Đorđević
Healthcare 2023, 11(5), 715; https://doi.org/10.3390/healthcare11050715 - 28 Feb 2023
Viewed by 1143
Abstract
Providing intensive informal caregiving can cause caregivers’ overburden, possibly impacting successful ageing factors such as physical and mental health and social life. This article aimed to investigate how informal caregivers experience the impact of providing care for chronic respiratory patients on the process [...] Read more.
Providing intensive informal caregiving can cause caregivers’ overburden, possibly impacting successful ageing factors such as physical and mental health and social life. This article aimed to investigate how informal caregivers experience the impact of providing care for chronic respiratory patients on the process of caregiver ageing. A qualitative exploratory study was performed using semi-structured interviews. The sample comprised 15 informal caregivers who provided intensive care for patients with chronic respiratory failure for more than six months. They were recruited while accompanying the patients on their examination for chronic respiratory failure in Special Hospital for Pulmonary Disease in Zagreb between January 2020 and November 2020. Semi-structured interviews were used with informal caregivers, and interview transcripts were analysed by the inductive thematic analysis method. Similar codes were organised into categories, and categories were grouped into themes. Two themes were identified in the domain of physical health relating to informal caregiving activities and inadequate treatment of their difficulties, three themes were in the domain of mental health relating to satisfaction with the recipient of care and feelings, and two themes were in the domain of social life, relating to social isolation and social support. Informal caregivers of patients with chronic respiratory failure experience a negative impact on the factors that contribute to the successful ageing of informal caregivers. The results of our research suggest that caregivers need support in maintaining their own health and social inclusion. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
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Other

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24 pages, 725 KiB  
Systematic Review
Factors Impacting Retention of Aged Care Workers: A Systematic Review
by Claire Thwaites, Jonathan P. McKercher, Deirdre Fetherstonhaugh, Irene Blackberry, Julia F-M. Gilmartin-Thomas, Nicholas F. Taylor, Sharon L. Bourke, Sally Fowler-Davis, Susan Hammond and Meg E. Morris
Healthcare 2023, 11(23), 3008; https://doi.org/10.3390/healthcare11233008 - 21 Nov 2023
Viewed by 4231
Abstract
Retention of care support workers in residential aged care facilities and home-based, domiciliary aged care is a global challenge, with rapid turnover, low job satisfaction, and poorly defined career pathways. A mixed-methods systematic review of the workforce literature was conducted to understand the [...] Read more.
Retention of care support workers in residential aged care facilities and home-based, domiciliary aged care is a global challenge, with rapid turnover, low job satisfaction, and poorly defined career pathways. A mixed-methods systematic review of the workforce literature was conducted to understand the factors that attract and retain care staff across the aged care workforce. The search yielded 49 studies. Three studies tested education and training interventions with the aim of boosting workforce retention and the remaining 46 studies explored opinions and experiences of care workers in 20 quantitative, four mixed-methods and 22 qualitative studies. A range of factors impacted retention of aged care staff. Two broad themes emerged from the analysis: individual and organisational factors facilitating retention. Individual factors related to personal satisfaction with the role, positive relationships with other staff, families, and residents, and a cooperative workplace culture. Organisational factors included opportunities for on-the-job training and career development, appropriate wages, policies to prevent workplace injuries, and job stability. Understaffing was often cited as a factor associated with turnover, together with heavy workloads, stress, and low job satisfaction. With global concerns about the safety and quality of aged care services, this study presents the data associated with best practice for retaining aged care workers. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
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