Vela Emili, Contel Joan Carles, Vila Anna, Santaeugènia Sebastià J, Suñol Rosa, Amblàs-Novellas Jordi, Barbeta Conxita, Plaza Aina, Hilarión Pilar
Àrea de Sistemes d'Informació, Servei Catalàde la Salut, Barcelona, Spain.
Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain.
Int J Integr Care. 2025 May 16;25(2):15. doi: 10.5334/ijic.8909. eCollection 2025 Apr-Jun.
This study aimed to evaluate the impact of integrating social and health home care services (HCSs) on institutionalization, survival, and utilization of health and social care services and associated expenditures.
Retrospective study including all individuals who initiated social HCSs for dependent people in Catalonia during 2018-2019 with a paired case-control, pre/post design (differences-in-differences), using integrated data from the Autonomy and Dependency Care System database and the Catalan Health Surveillance System. Individuals were categorized based on their perceived level of integration in the residing areas (high level: Case Group, and low level: Control Group).
We included 4381 cases and 13143 matched controls. HCS integration decreased the risk of institutionalization in a nursing home by 19.5% and the length of stays in any center by 7.7%. Integration increased day centers' use by 23.7% and primary care service utilization by 3.0%, and also reduced associated social expenditures after HCS initiation by 19.1% and overall social and health expenditures by 2.6%.
Integration of social and health HCSs resulted in a shift from institutionalization services to primary care services and day care centers, prolonging recipients' lives in their homes.
本研究旨在评估整合社会和健康居家护理服务（HCSs）对机构化、生存率、健康和社会护理服务利用情况以及相关支出的影响。
回顾性研究，纳入2018 - 2019年期间在加泰罗尼亚为依赖他人生活的人群启动社会HCSs的所有个体，采用配对病例对照、前后设计（差异中的差异），使用来自自主与依赖护理系统数据库和加泰罗尼亚健康监测系统的综合数据。个体根据其在居住地区的整合感知水平进行分类（高水平：病例组，低水平：对照组）。
我们纳入了4381例病例和13143例匹配对照。HCS整合使入住养老院的机构化风险降低了19.5%，在任何机构的住院时间缩短了7.7%。整合使日间护理中心的使用率提高了23.7%，初级保健服务利用率提高了3.0%，并且在启动HCS后还使相关社会支出降低了19.1%，总体社会和健康支出降低了2.6%。
社会和健康HCSs的整合导致了从机构化服务向初级保健服务和日间护理中心的转变，延长了接受者在家中的生活时间。
