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础耻迟丑辞谤蝉:听De Stampa,聽Matthieu;聽De Stampa,聽Matthieu;聽Buyck,聽Jean Fran莽ois;聽尝补辫辞颈苍迟别,听尝颈别迟迟别;聽Bergman,聽Howard;聽B茅land,聽Fran莽ois;聽Ankri,聽Jo毛l C.

笔耻产濒颈肠补迟颈辞苍:听Archives of Gerontology and Geriatrics, 2014

础产蝉迟谤补肠迟:听

Very frail elderly patients living in the community, present complex needs and have a higher rate of hospital admissions with emergency department (ED) visits. Here, we evaluated the impact on hospital admissions of the COPA model (CO-ordination Personnes Ag茅es), which provides integrated primary care with intensive case management for community-dwelling, very frail elderly patients. We used a quasi-experimental study in an urban district of Paris with four hundred twenty-eight very frail patients (105 in the intervention group and 323 in the control group) with one-year follow-up. The primary outcome measures were the presence of any unplanned hospitalization (via the ED), any planned hospitalizations (direct admission, no ED visit) and any hospitalization overall. Secondary outcome measures included health parameters assessed with the RAI-HC (Resident Assessment Instrument-Home Care). Comparing the intervention group with the control group, the risk of having at least one unplanned hospital admission decreased at one year and the planned hospital admissions rate increased, without a significant change in total hospital admissions. Among patients in the intervention group, there was less risk of depression and dyspnea. The COPA model improves the quality of care provided to very frail elderly patients by reducing unplanned hospitalizations and improving some health parameters. 漏 2014 Elsevier Ireland Ltd. All rights reserved.