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Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society

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

Deadline for manuscript submissions: 30 June 2024 | Viewed by 13008

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Special Issue Editor

Dr. Hidetaka Hamasaki

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Hamasaki Clinic, Nishida 2-21-4, Kagoshima, Japan
Interests: integrated healthcare; patient-centered care; chronic disease; diabetes; healthcare management
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Many developed countries are facing an ageing population and a declining birth rate. According to the World Health Organization, the population of those aged 60 years and older is expected to reach two billion by 2050. The sustainability of current healthcare systems is threatened by this rapidly ageing population. On the other hand, the number of patients with chronic diseases such as diabetes is also increasing worldwide, which represents a serious “pandemic”. Given that this increasing trend will continue, hospitals and clinics will overflow with older patients with diabetes, resulting in the collapse of healthcare systems. We are now required to establish an effective healthcare system in a super ageing society. For example, integrated healthcare that involves sharing information and coordination among healthcare providers, patients, healthcare organizations and communities is a useful tool to provide appropriate healthcare services to older patients who are physically and socially weak. Recent studies suggest that monitoring patients’ biological information, such as vital signs and physical activity, sharing the information between stakeholders and guiding patients to optimal healthcare services using remote monitoring systems will improve patients’ quality of life and mortality, and eventually reduce healthcare costs to society.

This Special Issue invites a broad spectrum of research topics regarding healthcare strategies for patients with chronic diseases including, but not restricted to, diabetes in an ageing society. We will compile original research articles, case reports, and critical reviews (narrative/systematic). The topics of this Special Issue include but are not limited to ageing society, patient-centered care, patient satisfaction, quality of care, diet and physical activity for frail elderly people, wearable devices, e-health, m-health, Internet of Things, digital solutions and other related topics.

Dr. Hidetaka Hamasaki
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.

Keywords

ageing society
integrated healthcare
patient-centered care
chronic disease
diabetes
physical activity
wearable device
E-health
M-health
healthcare system
sustainable healthcare

Published Papers (10 papers)

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Research

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13 pages, 261 KiB

Open AccessArticle

Person-Centred Care: A Support Strategy for Managing Non-Communicable Diseases

by Mateja Lorber, Nataša Mlinar Reljić, Barbara Kegl, Zvonka Fekonja, Gregor Štiglic, Adam Davey and Sergej Kmetec

Healthcare 2024, 12(5), 526; https://doi.org/10.3390/healthcare12050526 - 23 Feb 2024

Viewed by 604

Abstract

Background: Over the last decade, the inadequacy and unsustainability of current healthcare services for managing long-term co-morbid and multi-morbid diseases have become evident. Methods: This study, involving 426 adults with at least one non-communicable disease in Slovenia, aimed to explore the link between quality of life, life satisfaction, person-centred care, and non-communicable disease management. Results: Results indicated generally positive perceptions of quality of life, general health, and life satisfaction of individuals with non-communicable diseases. Participants assessed their physical health as the highest of the four quality of life domains, followed by the environment, social relations, and psychological health. Significant differences occurred in life satisfaction, general health, quality of life, and person-centred care for managing non-communicable diseases. But, there were no significant differences in person-centred care according to the living environment. The study revealed a positive association between person-centred care and effective non-communicable disease management, which is also positively associated with quality of life, general health, and life satisfaction. Conclusions: Person-centred care is currently the most compassionate and scientific practice conceived, representing a high ethical standard. However, implementing this approach in healthcare systems requires a cohesive national strategy led by capable individuals to foster stakeholder collaboration. Such an approach is crucial to address the deficiencies of existing healthcare services and ensure person-centred care sustainability in non-communicable disease management. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

11 pages, 914 KiB

Open AccessFeature PaperArticle

The Value of the COVID-19 Yorkshire Rehabilitation Scale in the Assessment of Post-COVID among Residents of Long-Term Care Facilities

by Łukasz Goździewicz, Sławomir Tobis, Michał Chojnicki, Katarzyna Wieczorowska-Tobis and Agnieszka Neumann-Podczaska

Healthcare 2024, 12(3), 333; https://doi.org/10.3390/healthcare12030333 - 28 Jan 2024

Cited by 1 | Viewed by 822

Abstract

The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a patient-reported outcome measure designed to assess the long-term effects of COVID-19. The scale was validated and is commonly used in the general population. In this study, we assess the utility of the C19-YRS in evaluating the post-COVID burden among residents of long-term care facilities with a mean age of 79. C19-YRS and Barthel index evaluations were performed among 144 residents of long-term care facilities reporting new or worsened symptoms or functioning three months after convalescence from COVID-19. The C19-YRS-based screening showed that 70.9% of COVID-19 convalescents had ≥1 complaint three months after recovery. The highest C19-YRS-scored symptoms (indicating a higher burden) were breathlessness, fatigue, and cognitive and continence problems; however, symptomatology was very heterogeneous, revealing a high complexity of the disease in older persons. The mean total C19-YRS score was higher in hospitalized patients (n = 78) than in the outpatient group (n = 66) (p = 0.02). The functioning subscale of the C19-YRS strongly correlated with the Barthel index, with r = −0.8001 (p < 0.0001). A moderately strong correlation existed between retrospectively reported C19-YRS-based functioning and the Barthel index score reported before illness (r = 0.7783, p < 0.0001). The C19-YRS is instrumental in evaluating the consequences of COVID-19 among long-term-care residents. The assessment allows for a broad understanding of rehabilitation needs. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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12 pages, 287 KiB

Open AccessArticle

Utilization of Primary Healthcare Services in Patients with Multimorbidity According to Their Risk Level by Adjusted Morbidity Groups: A Cross-Sectional Study in Chamartín District (Madrid)

by Jaime Barrio-Cortes, Almudena Castaño-Reguillo, Beatriz Benito-Sánchez, María Teresa Beca-Martínez and Cayetana Ruiz-Zaldibar

Healthcare 2024, 12(2), 270; https://doi.org/10.3390/healthcare12020270 - 20 Jan 2024

Viewed by 789

Abstract

Patients with multimorbidity have increased and more complex healthcare needs, posing their management a challenge for healthcare systems. This study aimed to describe their primary healthcare utilization and associated factors. A population-based cross-sectional study was conducted in a Spanish basic healthcare area including all patients with chronic conditions, differentiating between having multimorbidity or not. Sociodemographic, functional, clinical and service utilization variables were analyzed, stratifying the multimorbid population by the Adjusted Morbidity Groups (AMG) risk level, sex and age. A total of 6036 patients had multimorbidity, 64.2% being low risk, 28.5% medium risk and 7.3% high risk. Their mean age was 64.1 years and 63.5% were women, having on average 3.5 chronic diseases, and 25.3% were polymedicated. Their mean primary care contacts/year was 14.9 (7.8 with family doctors and 4.4 with nurses). Factors associated with primary care utilization were age (B-coefficient [BC] = 1.15;95% Confidence Interval [CI] = 0.30–2.01), female sex (BC = 1.04; CI = 0.30–1.78), having a caregiver (BC = 8.70; CI = 6.72–10.69), complexity (B-coefficient = 0.46; CI = 0.38–0.55), high-risk (B-coefficient = 2.29; CI = 1.26–3.32), numerous chronic diseases (B-coefficient = 1.20; CI = 0.37–2.04) and polypharmacy (B-coefficient = 5.05; CI = 4.00–6.10). This study provides valuable data on the application of AMG in multimorbid patients, revealing their healthcare utilization and the need for a patient-centered approach by primary care professionals. These results could guide in improving coordination among professionals, optimizing multimorbidity management and reducing costs derived from their extensive healthcare utilization. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

14 pages, 937 KiB

Open AccessArticle

Living Alone, Physical Health, and Mortality in Breast Cancer Survivors: A Prospective Observational Cohort Study

by Cassie Doyle, Eunjeong Ko, Hector Lemus, Fang-Chi Hsu, John P. Pierce and Tianying Wu

Healthcare 2023, 11(17), 2379; https://doi.org/10.3390/healthcare11172379 - 24 Aug 2023

Viewed by 919

Abstract

Living alone, particularly for individuals with poor physical health, can increase the likelihood of mortality. This study aimed to explore the individual and joint associations of living alone and physical health with overall mortality among breast cancer survivors in the Women’s Healthy Eating and Living (WHEL). We collected baseline, 12-month and 48-month data among 2869 women enrolled in the WHEL cohort. Living alone was assessed as a binary variable (Yes, No), while scores of physical health were measured using the RAND Short Form–36 survey (SF-36), which include four domains (physical function, role limitation, bodily pain, and general health perceptions) and an overall summary score of physical health. Cox proportional hazard models were used to evaluate associations. No significant association between living alone and mortality was observed. However, several physical health measures showed significant associations with mortality (p-values < 0.05). For physical function, the multivariable model showed a hazard ratio (HR) of 2.1 (95% CI = 1.02–4.23). Furthermore, the study examined the joint impact of living alone and physical health measures on overall mortality. Among women with better physical function, those living alone had a 3.6-fold higher risk of death (95% CI = 1.01–12.89) compared to those not living alone. Similar trends were observed for pain. However, regarding role limitation, the pattern differed. Breast cancer survivors living alone with worse role limitations had the highest mortality compared to those not living alone but with better role limitations (HR = 2.6, 95% CI = 1.11–5.95). Similar trends were observed for general health perceptions. Our findings highlight that living alone amplifies the risk of mortality among breast cancer survivors within specific health groups. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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13 pages, 504 KiB

Open AccessArticle

Towards Cultural Adequacy of Experience-Based Design: A Qualitative Evaluation of Community-Integrated Intermediary Care to Enhance the Family-Based Long-Term Care for Thai Older Adults

by Thin Nyein Nyein Aung, Thaworn Lorga, Saiyud Moolphate, Yuka Koyanagi, Chaisiri Angkurawaranon, Siripen Supakankunti, Motoyuki Yuasa and Myo Nyein Aung

Healthcare 2023, 11(15), 2217; https://doi.org/10.3390/healthcare11152217 - 07 Aug 2023

Viewed by 1333

Abstract

In this qualitative study, we provided an in-depth understanding of how Community-Integrated Intermediary Care (CIIC), a new service model for family-based long-term care (LTC), was perceived by its users. The CIIC, established in Chiang Mai, Northern Thailand, consisted of three main interventions: (1) A temporary respite care center; (2) A family-centered care capacity building; (3) Functional training delivered as community group exercise and home exercise to improve healthy ageing for independent older adults. Ten pairs of dependent Thai older adults, their primary family caregivers, and ten village health volunteers were recruited using the purposive sampling method. Data were collected via semistructured in-depth interviews. A thematic descriptive qualitative analysis was used for data analysis. The findings revealed that CIIC helped reduce the burden of family caregivers by providing respite, relief, and care coordination. The experiences of the CIIC users indicated possibilities for service redesign, development, and delivery strategies to better meet the LTC needs of older adults and family caregivers. Following the local stakeholders’ commitment and local community health volunteers’ network, a well-integrated formal and informal care CIIC model can be implied as an effective and sustainable ageing care service model in Thailand and other Asian countries in the future. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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12 pages, 422 KiB

Open AccessArticle

Poverty Reduction Effects of Medical Insurance on Middle-Aged and Elderly Families under the Goal of Common Prosperity in China

by Linhong Chen and Xiaocang Xu

Healthcare 2023, 11(4), 477; https://doi.org/10.3390/healthcare11040477 - 07 Feb 2023

Viewed by 1436

Abstract

Eliminating poverty due to illness is an important way for China to pursue common prosperity. The high medical expenditure caused by the aging population has brought severe challenges to governments and families of all countries, especially in China, where the entire population has just been lifted out of poverty in 2020 and then hit by COVID-19. How to prevent the possible return of poor boundary families to poverty in China has become a difficult research topic. Based on the latest data from the China Health and Retirement Longitudinal Survey, this paper discusses the poverty reduction effect of medical insurance on middle-aged and elderly families from the absolute index and relative index. Medical insurance had a poverty reduction effect on middle-aged and elderly families, especially the poor boundary families. For example, people who participated in medical insurance reduced their financial burden by 2.36% for middle-aged and older families compared to people who did not participate in medical insurance. Furthermore, the poverty reduction effect had heterogeneity in gender and age. This research brings some policy implications. For example, the government should give more protection to vulnerable groups such as the elderly and low-income families and improve the fairness and effectiveness of the medical insurance system. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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11 pages, 1410 KiB

Open AccessEditor’s ChoiceArticle

Preferred Place of End-of-Life Care Based on Clinical Scenario: A Cross-Sectional Study of a General Japanese Population

by Kyoko Hanari, Sandra Y. Moody, Takehiro Sugiyama and Nanako Tamiya

Healthcare 2023, 11(3), 406; https://doi.org/10.3390/healthcare11030406 - 31 Jan 2023

Cited by 1 | Viewed by 1372

Abstract

In Japan, which has an aging society with many deaths, it is important that people discuss preferred place for end-of-life care in advance. This study aims to investigate whether the preferred place of end-of-life care differs by the assumed clinical scenario. This clinical scenario-based survey used data from a nationwide survey conducted in Japan in December 2017. Participants aged 20 years and older were randomly selected from the general population. The survey contained questions based on three scenarios: cancer, end-stage heart disease, and dementia. For each scenario, respondents were asked to choose the preferred place of end-of-life care among three options: home, nursing home, and medical facility. Eight hundred eighty-nine individuals participated in this study (effective response rate: 14.8%). The proportions of respondents choosing home, nursing home, and medical facility for the cancer scenario were 49.6%, 10.9%, and 39.5%, respectively; for the end-stage heart disease scenario, 30.5%, 18.9%, and 50.6%; and for the dementia scenario, 15.2%, 54.5%, and 30.3% (p < 0.0001, chi-square test). The preferred place of end-of-life care differed by the assumed clinical scenario. In clinical practice, concrete information about diseases and their status should be provided during discussions about preferred place for end-of-life care to reveal people’s preferences more accurately. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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15 pages, 1357 KiB

Open AccessArticle

A Brief mHealth-Based Psychological Intervention in Emotion Regulation to Promote Positive Subjective Well-Being in Cardiovascular Disease Patients: A Non-Randomized Controlled Trial

by Naima Z. Farhane-Medina, Rosario Castillo-Mayén, Bárbara Luque, Sebastián J. Rubio, Tamara Gutiérrez-Domingo, Esther Cuadrado, Alicia Arenas and Carmen Tabernero

Healthcare 2022, 10(9), 1640; https://doi.org/10.3390/healthcare10091640 - 28 Aug 2022

Cited by 2 | Viewed by 1870

Abstract

The emotional impact that a cardiovascular disease may have on a person’s life can affect the prognosis and comorbidity of the disease. Therefore, emotion regulation is most important for the management of the disease. The aim of this study was to analyze the effectiveness of a brief mHealth psychological intervention in emotion regulation to promote positive subjective well-being in cardiovascular disease patients. The study sample (N = 69, 63.7 ± 11.5 years) was allocated to either the experimental group (n = 34) or control group (n = 35). The intervention consisted of a psychoeducational session in emotion regulation and an mHealth-based intervention for 2 weeks. Positive subjective well-being as a primary outcome and self-efficacy to manage the disease as a secondary outcome were assessed at five time points evaluated over a period of 6 weeks. The experimental group showed higher improvement in positive subjective well-being and self-efficacy for managing the disease compared to the control group over time. The experimental group also improved after the intervention on all outcome measures. Brief mHealth interventions in emotion regulation might be effective for improving positive subjective well-being and self-efficacy to manage the disease in cardiovascular patients. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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Review

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14 pages, 261 KiB

Open AccessReview

Horticultural Therapy for Individuals Coping with Dementia: Practice Recommendations Informed by Related Non-Pharmacological Interventions

by Matthew J. Wichrowski and Monica Moscovici

Healthcare 2024, 12(8), 832; https://doi.org/10.3390/healthcare12080832 - 15 Apr 2024

Viewed by 316

Abstract

Dementia care currently presents a challenge to healthcare providers on many levels. The rapid increase in the number of people with dementia and the costs of care certainly contribute to these challenges. However, managing the behavioral and psychological symptoms of dementia (BPSDs) has become one of the most significant tasks in providing care and can lead to poor health and well-being outcomes, not only for the people living with dementia (PLWD) but also for those providing their care. Cost-effective, easily implemented, highly adaptable, empirically based alternatives are needed. Interventions such as Horticultural Therapy (HT), which is naturally informed by Montessori-Based Methods for Dementia and sensory reminiscence therapies, meets these qualifying factors. This article, based on a review of current best practices and clinical experience, hopes to provide recommendations for such an intervention along with special considerations for PLWD and adaptations for different acuity levels. With additional safe and effective, person-centered, non-pharmacological interventions available for the complex cognitive and neuropsychiatric manifestations of this disease, a better care milieu can be provided, improving the quality of life for both patients and caregivers. This article also identifies the need for continued research into the synergistic effects of person-centered behavioral and psychosocial interventions combined with environmental approaches to provide the optimal healing environment for those coping with dementia. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

15 pages, 976 KiB

Open AccessEditor’s ChoiceReview

Patient Satisfaction with Telemedicine in Adults with Diabetes: A Systematic Review

by Hidetaka Hamasaki

Healthcare 2022, 10(9), 1677; https://doi.org/10.3390/healthcare10091677 - 02 Sep 2022

Cited by 6 | Viewed by 2461

Abstract

Patient satisfaction assessment is essential for improving the quality of healthcare. Diabetes management using telemedicine technology is promising in the 21st century. However, the number of randomised controlled trials (RCTs) examining the effect of telemedicine on satisfaction in patients with diabetes is limited. This systematic review aimed to summarise the current evidence on patient satisfaction with telemedicine in adults with diabetes and discuss related issues and future directions of telemedicine in patients with diabetes. The author systematically searched PubMed/MEDLINE, Embase and The Cochrane Library, and a total of six RCTs were eligible for this review. Patient satisfaction with telemedicine was as high as conventional face-to-face care; however, telemedicine appeared not to significantly increase patient satisfaction compared with conventional face-to-face care in the included studies. Significant heterogeneity was noted between the studies, including participants’ age, study duration, the method of assessing patient satisfaction and types of telemedicine. Further studies are required to provide firm evidence to healthcare providers who are willing to use telemedicine in diabetes management. Telemedicine technology has been advancing and is a key tool in providing high-quality healthcare to patients with diabetes in the 21st century. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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