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Introduction: This study aimed to assess the implementation of integrated social and health home care services (HCS) offered by the Government of Catalonia, and to identify the main barriers and facilitators of integrated HCS. Methods: Analysis of the degree of implementation of integrated social and health HCS perceived by social care services (SCS) and primary health care centers (PHCs) between December 2020 and June 2021 in two phases. First, the perception of integration by social workers within SCS and PHCs was assessed using a screening questionnaire. Then, SCS in counties with the highest integration scores received a customized questionnaire for an in-depth assessment. Results: A total of 105 (100%) SCS and 94 (25%) PHCs answered the screening questionnaire, and 48 (45.7%) SCS received a customized questionnaire. The most frequent barrier identified was the lack of shared protocols, with the most frequent facilitator being the recognition of the importance of integrated HCS. Conclusions: Our study showed that the degree of implementation of integrated health and social HCS offered by the Government of Catalonia was perceived as low. The identified barriers and facilitators can be used to facilitate such implementation. Further studies should include professionals other than social workers in PHC assessments. [ABSTRACT FROM AUTHOR]

Introduction: There is small knowledge in the literature related to people with Home Healthcare (HHC) and Social Home Care (SHC) in the community. Both HHC and SHC are responsibilities and activities performed by different Ministries and Local Government. Very few tools facilitate collaborative practice between different professionals teams and services working in the home care area. Aims Objectives Theory or Methods: Objectives: Analyse and describe population with both Home healthcare and Social home care services -Analyse impact of Integrated Home Care services in population living at home requiring home care services Methods: → PHASE 1: Analysis of the level of deployment and degree of achievement of key contents related to a model of integrated care for the different regions of Catalonia: unique shared assessment instruments, individual single care plan, shared protocols. → PHASE 2: Evaluate the impact of healthcare on adequacy of use and demand, efficiency and capacity; with indicators of use of services, such as hospitalizations, institutionalization and primary care use Highlights or Results or Key Findings Aggregate average score of each of the indicators used in the analysis of the baseline situation of the Integrated Care in home care services was 1.4 out of 5, representing 27.5% of the maximum score. Integrated Home Care decreases the probability of being institutionalized in a nursing home by 20% and decreases the number of cumulative days of hospitalization in health centres by 2.3%. Primary care visits increases by 2.1%, 6.4% in the case of home healthcare visits and 3,2% virtual visits. No significant impact on hospital admissions was observed. Integrated Home Care implies that overall increase in social and health spending decreases by 2.2%. There is no significant variation in health expenditure, as the increase in community and outpatient health expenditure by 3.8%, compared to the decrease in inpatient health expenditure (hospitals and social health). There is a significant impact on the increase in social spending by 16.8%. Conclusions: Among the most valued elements: lack of protocols, culture of little coordination between health and social care, high demanding situation, perception of deficit of political mandate, lack of shared information systems and scarcity of professionals. Among most mentioned facilitating factors: good attitude and recognition of need of Integrated Care. Implications for applicability/transferability sustainability and limitations: This experience of evaluating the impact of integrated home care is the first time carried out in Catalonia. There is a great challenge of overcoming the barrier in terms of data protection, in terms of work with aggregated health and social data, with highly explanatory potential use. [ABSTRACT FROM AUTHOR]

Introduction: Integrated health and social care is a policy priority in Catalonia. During COVID pandemics impact in care home has been huge in terms of incidence, hospitalization and death. Mortality in care home related to COVID has been in Catalonia 40% of all deaths related to COVID In global population. There have been a great effort of all health and social care system to give appropriate response to severe situation in care homes. Integrated Care approach has been an essential key component in the model of care as both Health Care and Care Homes are responsibilities taken by different ministries. Aims Objectives Theory or Methods: Objectives: 1) Evaluate the current maturity level of and readiness for integrated care in care homes in different territories in Catalonia. 2) Assess the current situation that allows identifying breeding lines for the updating and progress in IC model in care homes. The SCIROCCO Exchange self-assessment tool (see: https://scirocco-exchangetool. inf.ed.ac.uk/en_gb/) is a self-assessment tool to assess a region's readiness and maturity for integrated care. It builds on the conceptual Maturity Model for Integrated Care developed by the B3 Action Group on Integrated Care of the European Innovation Partnership on Active and Healthy Ageing. 190 professionals from 18 regions were assessed. Highlights or Results or Key Findings: Relatively low scores in all 12 dimensions in SCIROCCO maturity model. Remarkable increase in 2021 scores compared to the pre-pandemic situation scores. Territorial differences exist even if rurality does not seem to be a determinant factor in IC in care homes maturity. "Structure and governance" and "Breadth of ambition" among the highest rated SCIROCCO dimensions and "Funding" and "Evaluation methods" among the lowest rated in both individual self-assessments and consensus self-assessments. "Structure and governance" and "Breadth of ambition" among SCIROCCO dimensions that increase the most their scores in the current situation compared to the pre-pandemic situation. Some valuable qualitative information is identified as areas to be improved: need of better labour conditions, need of a share and integrated health and social information and interoperable health and care record, need of incorporating a more systemic and comprehensive perspective with demographic segmentation and stratification approach. Theses qualitative information will be incorporated in updated IC model. Conclusions: Before pandemics, development of Integrated care in residential care has been scarce. During pandemics, Integrated Care approach has been adopted both at ministries level and regional level implementing a range of Integrated Care initiatives to cope with vulnerable situation of people living in care homes in Catalonia. Implications for applicability/transferability sustainability and limitations: Integrated Care policy and action in care homes should be maintained overtime and reinforced in last stage of pandemics to create a scenario of collaborative work and transformation in residential care. IC should be incorporated in other long term care policies (home care, ...) in new updated design and implementation. [ABSTRACT FROM AUTHOR]

An introduction comprising background and problem statement: The role of caregivers of people suffering one or more chronic conditions has been analyzed and stablished, but there are no tools to measure their experience as caregivers with health and social professionals and services in a cost-effective manner. Subsequently, efforts to improve it may result uncertain. There is a need to have a validated instrument to assess caregiver experience. Theory/Methods: We adapted IEXPAC to measure the experience of non-professional caregivers of people suffering one or more chronic conditions. IEXPAC is a validated scale that measures patient experience ref ICIC, www.iexpac.org. IEXPAC defines patient experience as the information that the person facilitates on what has happened to her in her continued interaction with the health and social care professionals and services and on how she has lived that interaction and its outcomes. This is an observational study that applies discussion group technique to a random selection of 8 non-professional caregivers 67 year-old average, 16 year of experience as caregiver of a family member, with Alzheimer in 5/8, mental disorder in 3/8 and EPOC in 2/8 of the cases to adapt IEXPAC questionnaire. The resulting caregiver questionnaire was administered to 122 caregivers of similar profile. Results: 10 out of 16 items got 5/5 points in comprehension of the statements. All responses were in the 2,3-5 range. In two items, small modifications were proposed and accepted to improve clarity. Caregivers considered that the explored dimensions addressed he most relevant aspects of their experience as caregivers average of 5 points. The 5 step Likert scale never to always was considered easier 5/8 than the completely agree to completely disagree scale 3/8. 7/8 respondents consider the filling in paper facilitated response while 2/8 did the same with filling in internet. Experience with health and social integrated care was assessed by 122 caregivers referred to coordination and continuity of care among all the implied professionals, respect to values and preferences, support to improve care competencies, address caregiver stress and overload, use of new technologies to facilitate interaction, and commitment to improve wellbeing. Discussions: The highest challenges needed are related to support to improve care competencies and the use of new technologies to facilitate interaction. Conclusions comprising key findings: The measurement of caregivers experience might contribute to improve integrated care by incorporating the emotional, informational and personal needs of the people who assume the care of chronic patients. IEXPAC caregivers is an instrument that joins acceptability, easiness of use and utility perceived by the own users. Lessons learned: Caregivers feel relieved and reassured in their role as feel they are taken into account by health services. Limitations: Older caregivers tend to positive assessments. Suggestions for future research: The social networks sites could be modified the caregivers experience of loneliness and relief. [ABSTRACT FROM AUTHOR]