Impact of Integrating Social and Health Home Care Services in Catalonia: A Retrospective Cohort-Based Two-Year Study
Por:
Vela E, Contel JC, Vila A, Sebastià Santaeugènia Gonzàlez, Suñol R, Amblàs-Novellas J, Barbeta C, Plaza A and Hilarión P
Publicada:
1 abr 2025
Ahead of Print:
16 may 2025
Resumen:
Introduction: 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. Methods: 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). Results: 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%. Conclusion: 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.
Filiaciones:
Vela E:
Àrea de Sistemes d'Informació, Servei Catalàde la Salut, Barcelona, Spain
Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
Contel JC:
Integrated Social and Health Care Program, Department of Health and Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
General Directorate of Health Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
Vila A:
Integrated Social and Health Care Program, Department of Health and Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
General Directorate of Personal Autonomy and Disability, Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
Sebastià Santaeugènia Gonzàlez:
General Directorate of Health Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
Intermediate Care Director, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Suñol R:
Avedis Donabedian Research Institute (FAD), Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Health Services Research Network on Chronic Diseases (REDISSEC), Spain
Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
Amblàs-Novellas J:
Integrated Social and Health Care Program, Department of Health and Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
General Directorate of Health Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
Barbeta C:
Integrated Social and Health Care Program, Department of Health and Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
General Directorate of Personal Autonomy and Disability, Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
Plaza A:
Integrated Social and Health Care Program, Department of Health and Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
General Directorate of Personal Autonomy and Disability, Department of Social Rights, Generalitat de Catalunya, Barcelona, Spain
Hilarión P:
Avedis Donabedian Research Institute (FAD), Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Health Services Research Network on Chronic Diseases (REDISSEC), Spain
Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
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