Sturge Jodi, Nordin Susanna, Pilosof Nirit Putievsky, Vogt Tobias, Janus Sarah I M, Ludden Geke, Helder Ronald, Kylén Maya, Zimlichman Eyal, Glazer Jacob
Faculty of Engineering Technology, University of Twente, Enschede, The Netherlands
School of Health and Welfare, Dalarna University, Falun, Sweden.
BMJ Open. 2025 Apr 2;15(4):e096385. doi: 10.1136/bmjopen-2024-096385.
Ageing right care(fully) is a transnational research study which explores and maps an understanding of the care pathways between ageing in place and hospital at home policy and practices for older adults in Israel, the Netherlands and Sweden. The countries are suited to be compared where they have growing, ageing populations, a focus on healthcare reform and several policies to reduce the cost of care for older populations. Ageing in place is a government-led policy that is often associated with choice; however, there is a recent debate about whether ageing in place is a universal desire for all older adults. Research shows that the care pathway between the hospital and the home, associated with ageing in place, can impact well-being, especially if the built, social and technological environments do not meet the healthcare needs and preferences of older adults. This is significant as new programmes for digital hospital at home innovations are being developed as part of a global transformation in healthcare systems. The aim of the study is to compare different approaches to ageing in place and hospital at home care in different regions. The multiapproach study explores the demographics, policy structure, decision-making process and the crucial role of the built, social and technological environments along the hospital to home care pathways of older adults.
The mixed-method, comparative study includes a new multienvironment theoretical contribution explored across a three-phase research method to understand the care pathways of older adults ageing in place receiving hospital at home care. The first phase compares each country's population and policy structures relating to ageing in place, hospital discharge, home hospitalisation and at-home care for older adults. The second phase maps patient journeys of older adults living in each country through the perspective of the older adult, caregivers and care professionals. The third phase explores the synergies between the knowledge gained through phases 1 and 2-from a policy and a personal level-and mobilises the knowledge into policy recommendations and implementation guidelines.
The comparative study has been approved by the Sheba Medical Centre in Israel (SMC-1330-24), the Ethics Committee of Tel Aviv University (0009216-2), the Humanities and Social Science Ethics Committee at the University of Twente in the Netherlands (240040) and the Swedish Ethical Review Authority (Dnr 2024-07569-01). The results will be shared with end-users, including citizens, carers, healthcare policymakers, planners, architects and designers, through social media, publications, workshops and international conferences. This future-focused research approach will allow stakeholders to rethink and imagine ways that health and care systems can be personalised and responsive to the future needs of older adult populations.
“适老妥护”是一项跨国研究，旨在探索并梳理以色列、荷兰和瑞典针对老年人的就地养老政策与居家医院护理政策及实践之间的护理路径认知。这些国家在人口老龄化不断加剧、注重医疗改革以及出台多项降低老年人口护理成本政策的背景下，适合进行比较研究。就地养老是一项由政府主导的政策，通常与选择相关；然而，近期对于就地养老是否是所有老年人普遍期望的问题存在争议。研究表明，与就地养老相关的医院与家庭之间的护理路径会影响老年人的幸福感，尤其是当建筑、社会和技术环境无法满足老年人的医疗需求和偏好时。鉴于作为医疗系统全球转型一部分的新型居家数字医院创新项目正在开发，这一点意义重大。该研究旨在比较不同地区就地养老和居家医院护理的不同方法。这项多方法研究探讨了老年人从医院到家庭护理路径中的人口统计学、政策结构、决策过程以及建筑、社会和技术环境的关键作用。
这项混合方法的比较研究包括一项新的多环境理论贡献，通过三个阶段的研究方法进行探索，以了解接受居家医院护理的就地养老老年人的护理路径。第一阶段比较每个国家与就地养老、医院出院、居家住院和老年人居家护理相关的人口和政策结构。第二阶段从老年人、护理人员和护理专业人员的角度绘制每个国家老年人的就医过程。第三阶段探索通过第一阶段和第二阶段从政策层面和个人层面获得的知识之间的协同作用，并将这些知识转化为政策建议和实施指南。
这项比较研究已获得以色列谢巴医疗中心（SMC - 1330 - 24）、特拉维夫大学伦理委员会（0009216 - 2）、荷兰特温特大学人文与社会科学伦理委员会（240040）以及瑞典伦理审查局（编号2024 - 07569 - 01）的批准。研究结果将通过社交媒体、出版物、研讨会和国际会议与最终用户分享，包括公民、护理人员、医疗政策制定者、规划者、建筑师和设计师。这种着眼未来的研究方法将使利益相关者能够重新思考并设想如何使卫生和护理系统实现个性化，并满足老年人口未来的需求。
