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dc.contributor.authorGordon , Adam
dc.contributor.authorGoodman, Claire
dc.contributor.authorDavies, Sue L
dc.contributor.authorDening , Tom
dc.contributor.authorGage, Heather
dc.contributor.authorMeyer, Julienne
dc.contributor.authorSchneider, Justine
dc.contributor.authorBell , Brian
dc.contributor.authorJordan , Jake
dc.contributor.authorMartin , Finbarr
dc.contributor.authorIliffe , Steve
dc.contributor.authorBowman, Clive
dc.contributor.authorGladman, John
dc.contributor.authorVictor, Christina
dc.contributor.authorMayrhofer, Andrea
dc.contributor.authorHandley, Melanie
dc.contributor.authorZubair , Maria
dc.date.accessioned2018-02-08T17:59:59Z
dc.date.available2018-02-08T17:59:59Z
dc.date.issued2018-07-01
dc.identifier.citationGordon , A , Goodman , C , Davies , S L , Dening , T , Gage , H , Meyer , J , Schneider , J , Bell , B , Jordan , J , Martin , F , Iliffe , S , Bowman , C , Gladman , J , Victor , C , Mayrhofer , A , Handley , M & Zubair , M 2018 , ' Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes ' , Age and Ageing , vol. 47 , no. 4 , pp. 595–603 . https://doi.org/10.1093/ageing/afx195
dc.identifier.issn0002-0729
dc.identifier.otherORCID: /0000-0002-8037-5042/work/42619069
dc.identifier.otherORCID: /0000-0002-8938-4893/work/62749734
dc.identifier.urihttp://hdl.handle.net/2299/19758
dc.descriptionThis is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
dc.description.abstractIntroduction: care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. Methods: a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. Results: context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. Conclusion: activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.en
dc.format.extent9
dc.format.extent559019
dc.language.isoeng
dc.relation.ispartofAge and Ageing
dc.subjectHealth services for the aged
dc.subjectHomes for the aged
dc.subjectNursing homes
dc.subjectOlder people
dc.subjectPrimary care
dc.subjectAgeing
dc.subjectGeriatrics and Gerontology
dc.titleOptimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomesen
dc.contributor.institutionSchool of Health and Social Work
dc.contributor.institutionCentre for Research in Public Health and Community Care
dc.contributor.institutionOlder People's Health and Complex Conditions
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionDepartment of Adult Nursing and Primary Care
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85054521359&partnerID=8YFLogxK
rioxxterms.versionofrecord10.1093/ageing/afx195
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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