A criticism of conventional office or clinic-based models of care is that they focus on patients'urgent problems and do not provide the comprehensive assessments, education, and psychosocial support that vulnerable patients also need.
Innovative models have emerged to address these needs.
A systematic review of prospective studies involving searches of computerized databases, reviews of reference lists, and contacts with authors, was conducted to determine whether multidisciplinary teams, outreach or home care, and case management improve the quality of the care in two vulnerable populations-the terminally ill and the mentally ill.
Literature searches identified 730 citations. 52 original articles met screening standards, and 24 studies fulfilled all criteria.
Patient and caregiver satisfaction was consistently higher with innovative models.
Functional, clinical, or psychological improvements were not consistently demonstrated.
For mentally ill patients, multi-disciplinary outreach strategies were effective in reducing inpatient hospitalizations.
Costs were inadequately assessed in the studios to draw a summary conclusion.
Like other interventions, health care delivery models can be assessed from an evidence-based perspective. (...)
Mots-clés Pascal : Innovation, Etude critique, Bibliographie, Santé mentale, Qualité, Soin, Malade, Stade terminal
Mots-clés Pascal anglais : Innovation, Critical study, Bibliography, Mental health, Quality, Care, Patient, Terminal stage
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 14/12/1999.