CIHR Health System Impact Fellow (former), AdvantAge Ontario, Woodbridge, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
BMC Geriatr. 2021 Jan 20;21(1):70. doi: 10.1186/s12877-020-01781-8.
As demand and desire to "age-in-place" grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors' Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.
This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario, Canada. Onsite in-person and phone interviews with senior campus staff (N = 30), and campus partners (N = 11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.
Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed.
Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, and improved access to shared resources, expertise and infrastructure. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.
随着老龄化人口对“就地养老”的需求和愿望不断增长，以及新的需求领域不断出现，各国政府都在关注创新和综合的方法，以促进健康和幸福感。老年人校园连续体是一种护理模式，旨在扩大获得一系列服务和住房选择的机会，以满足老龄化人口日益增长的健康和社会需求。本研究的目的是增加对这一模式及其影响因素的理解，这些因素影响着该模式的演变、发展、持续运作以及整合护理能力，以满足希望在自己家中和社区中养老的老年人的需求。
本研究采用跨案例比较研究方法，对加拿大安大略省六个有边界的案例进行了研究，这些案例提供了四个在不同背景下的地理上相邻的组成部分（混合住房选择、内部和外部社区支持以及长期护理院）。通过对老年人校园工作人员（N=30）和校园合作伙伴（N=11）进行现场和电话访谈，并在校园进行直接观察，探讨了为老年人提供健康、住房和社会护理连续体的历史和当前努力。
分析突出了八个关键因素。有利因素包括：i. 帮助有需要的人的丰富历史遗产；ii. 组织愿景和利用机会窗口的准备；iii. 利用组织结构和能力；iv. 有目的的物理和社会设计；v. 广泛的服务组合、便利设施和创新伙伴关系。阻碍因素包括：vi. 政策障碍和僵化；vii. 人力资源短缺和不平等；以及 viii. 资金限制。还观察到校园在不同层面提供的许多好处。
本研究的结果强调了在许多层面上优化校园潜力的机会。在个人层面上，校园增加了当地获得协调的健康和社会护理服务、支持和住房选择的机会。在组织层面上，校园为各提供者和合作伙伴提供了更多的合作机会，以提高护理的一致性和协调性，并改善对共享资源、专业知识和基础设施的访问。在系统层面上，校园可以解决各种健康、社会、财务和住房需求，帮助老年人避免过早或不适当地使用更高强度的护理环境。
