People with chronic wounds cared for at home in Belgium: Prevalence and exploration of care integration needs using health care trajectory analysis

Background: Little is known about the prevalence of people with chronic wounds cared for at home and their care integration needs in Belgium. In high-income countries, chronic wounds are associated with ageing processes, chronic diseases and social and financial vulnerability, resulting in multiple needs. To meet these needs, many health care providers (with nurses figuring prominently) are involved. This can lead to fragmented health care trajectories and the need to strengthen care coordination. Objectives: This study aims to estimate the prevalence of people with chronic wounds cared for at... Mehr ...

Verfasser: Alvarez Irusta, Lucia
Van Durme, Thérèse
Lambert, Anne-Sophie
Macq, Jean
Dokumenttyp: Artikel
Erscheinungsdatum: 2022
Verlag/Hrsg.: Elsevier BV
Schlagwörter: General Nursing / Chronic wounds / Home care / Health care trajectory / Prevalence study / Fragmentation of care / Coordination of care / Continuity of patient care
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27377461
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1016/j.ijnurstu.2022.104349

Background: Little is known about the prevalence of people with chronic wounds cared for at home and their care integration needs in Belgium. In high-income countries, chronic wounds are associated with ageing processes, chronic diseases and social and financial vulnerability, resulting in multiple needs. To meet these needs, many health care providers (with nurses figuring prominently) are involved. This can lead to fragmented health care trajectories and the need to strengthen care coordination. Objectives: This study aims to estimate the prevalence of people with chronic wounds cared for at home in Belgium. It also seeks to explore their health care trajectories and the risk of fragmentation of care to inform policy makers, care providers and research. Design: Cross-sectional. Setting(s): Home care. Participants: Routinely collected data of reimbursed care of 3467 people with a chronic wound cared for at home in 2018. Methods: We applied a stratification method to our sample based on health care trajectories. First, we constructed individual sequences of care received during the year. Then we summarised the health care events using a K-mers approach. Finally, a multinomial mixture model was used on the previously obtained summary to cluster individuals according to their health care trajectories. Afterwards, other epidemiological, socioeconomic and health care use indicators were calculated for each health care trajectory group. We also estimated the prevalence of people with chronic wounds treated at home. Results: We constructed six health care trajectory groups for two age categories (<65 and ≥65 years) showing different intensity of care use and type of care. In some health care trajectory groups, generalist care was found to be predominant. In others, specialist care appeared more prevalent. Depending on the health care trajectory group, a significant proportion of people had multiple care providers involved (mainly nurses, medical specialists and GPs), and many of them also had multiple transitions ...