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Health Care and Services

Section Co-ordinator: Edeltraut Kröger

Research Interests and Objectives

The Health Care and Services Research Section of the Quebec Network for Research on Aging studies the organization and evaluation of integrated systems for delivering health care and services to the elderly. The Section does this work in collaboration with two major multi-institutional research programs in Quebec that the Network helped to found: PRISMA (the Program of Research To Integrate Services for the Maintenance of Autonomy) and SOLIDAGE (the McGill University/University of Montreal Research Group on Integrated Services for Older Persons).

The Section also does research on the evaluation of geriatric services in hospitals. Its projects in this area include evaluating the quality of management of falls, the appropriateness of hospitalizations, and the use of emergency-room services by the elderly.

Lastly, the Section does research on frailty in older persons (in association with the Canadian Initiative on Frailty and Aging) and on evaluating the quality of care for the frail elderly population.

Achievements

In research on integrated care and service delivery systems, after Section members had participated in a pilot study of such a system in Quebec’s Bois-Francs district, the Network provided support to establish the PRISMA program. The SOLIDAGE program also was created with the Network’s support, following a preliminary evaluation of the SIPA (integrated services for older persons) project. SOLIDAGE subsequently obtained one grant from the Canadian Health Services Research Foundation to continue evaluating SIPA and another grant from the Canadian Institutes of Health Research for an Interdisciplinary Health Research Team to work on a project entitled “The challenge of understanding and meeting the needs of frail older persons in the Canadian health care system”. The SOLIDAGE group now includes investigators not only from its two founding universities, but also from Laval University and other universities in Canada, Europe, and the United States.

The support provided to the Network’s Health Care and Services Section has thus helped to develop instruments for measuring patient satisfaction with health care and services and the quality and cost of such care and services. This support has also contributed to the development of clinical tools, including interdisciplinary protocols, the ISO-SMAF functional autonomy profile, and a Computerized Clinical File. These research instruments and clinical tools were developed in collaboration with the Network’s Family and Professional Caregivers and Geriatric Rehabilitation research sections.

In research on evaluating hospital geriatric services, the Health Care and Services Section, along with the Merck Frosst pharmaceutical firm and the SOLIDAGE program, provided support for pilot studies on evaluating the management of geriatric patients who have experienced falls as an indicator of the overall quality of hospital geriatric care and services. The data gathered in these studies led to a CIHR operating grant for a joint project that is now under way on this subject. The Section has also provided support for a joint research initiative by McGill University, Laval University, University of Montreal, SOLIDAGE, and the regional and central offices of the Quebec ministry of health and social services to measure the appropriateness of hospitalizations of older persons in the various medical disciplines.

The Section has provided support as well for a pilot project that enabled the Groupe de recherche sur les urgences (emergency medicine research group) to secure a grant from the FRSQ (Quebec fund for health research) for a study on use of emergency room services that will include research specific to older persons.

In their research on frailty, Section members are working to clarify this concept, to establish a research program on it, and to develop recommendations about it for decision-makers and clinicians. The Section has also been involved in launching the Canadian Initiative on Frailty and Aging, in financial partnership with the Max Bell Foundation of Calgary and several Canadian and European research groups.

In the Section’s research on evaluating health care and services quality, it has also begun a new project designed to develop indicators for the quality of health care and services being delivered to vulnerable elderly persons, regardless of the settings in which they are living or receiving the care and services in question. This project was initiated by researchers who had participated in the SOLIDAGE and PRISMA programs. A CIHR grant was obtained to carry out a pilot project in 2005.

 

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