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2 results on '"Mari Aaltonen"'

1. Optimising the care for older persons with complex chronic conditions in home care and nursing homes: design and protocol of I-CARE4OLD, an observational study using real-world data

Author

John P Hirdes, Hao Luo, Davide L Vetrano, Graziano Onder, Jonathan Chen, Violetta Kijowska, Katarzyna Szczerbińska, Johanna Edgren, Amaia Calderón-Larrañaga, George Heckman, Ron MC Herings, Johanna de Almeida Mello, Anja Declercq, Mark Hoogendoorn, Caitlin McArthur, Mari Aaltonen, Yi Chai, Karlijn J Joling, Micaela Jantzi, Rosa Liperoti, Melissa Northwood, Ilona Barańska, Agata Stodolska, Margaret Saari, Luca Mariotti, Emiel O Hoogendijk, Luke Turcotte, Louk Smalbil, Elizabeth P Howard, John N Morris, Daniela Fialová, Eline CM Kooijmans, Riikka-Leena Leskelä, Jokke Häsä, Georg Ruppe, Hein PJ van Hout, Carmen Angioletti, Olena Antonenko, Shireen Aziz, Gustavo Betini, Jovana Brkič, Roberto Da Cas, Daniel Da Cunha Leme, Lu Dai, Cecilia Damiano, Natalia Drapała, Bonaventure Egbujie, Collin JC Exmann, Harriet Finne-Soveri, Charlene France, Tiziana Grisetti, Ira Haavisto, Sophie Hogeveen, Paweł Jagielski, Laurian Jongejan, Jet E Klunder, Ingrid Kummer, Anna Lukačišinová, Matti Mäkelä, Krista Mathias, Amanda Mofina, Reem Mulla, Mikko Nuutinen, Sandra Ochwat, Paula Pennanen, Jitka Pokladníková, Bregtje Proost, Ahmer Raza, Emanuele Rocco Villani, Jindra Reissigová, Erez Schachter, Katarzyna Sekulak, Chi-Ling Joanna Sinn, Andrea Vokálová, and Adrianna Ziuziakowska

Subjects
Medicine
Abstract

Introduction In ageing societies, the number of older adults with complex chronic conditions (CCCs) is rapidly increasing. Care for older persons with CCCs is challenging, due to interactions between multiple conditions and their treatments. In home care and nursing homes, where most older persons with CCCs receive care, professionals often lack appropriate decision support suitable and sufficient to address the medical and functional complexity of persons with CCCs. This EU-funded project aims to develop decision support systems using high-quality, internationally standardised, routine care data to support better prognostication of health trajectories and treatment impact among older persons with CCCs.Methods and analysis Real-world data from older persons aged ≥60 years in home care and nursing homes, based on routinely performed comprehensive geriatric assessments using interRAI systems collected in the past 20 years, will be linked with administrative repositories on mortality and care use. These include potentially up to 51 million care recipients from eight countries: Italy, the Netherlands, Finland, Belgium, Canada, USA, Hong Kong and New Zealand. Prognostic algorithms will be developed and validated to better predict various health outcomes. In addition, the modifying impact of pharmacological and non-pharmacological interventions will be examined. A variety of analytical methods will be used, including techniques from the field of artificial intelligence such as machine learning. Based on the results, decision support tools will be developed and pilot tested among health professionals working in home care and nursing homes.Ethics and dissemination The study was approved by authorised medical ethical committees in each of the participating countries, and will comply with both local and EU legislation. Study findings will be shared with relevant stakeholders, including publications in peer-reviewed journals and presentations at national and international meetings.

Published
2023
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2. Changes in older people’s care profiles during the last 2 years of life, 1996–1998 and 2011–2013: a retrospective nationwide study in Finland

Author

Leena Forma, Marja Jylhä, Jani Raitanen, Jutta Pulkki, Mari Aaltonen, Pekka Rissanen, Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences, and University of Tampere

Subjects
Male, Patient Transfer, Time Factors, Population level, Cross-sectional study, 03 medical and health sciences, 0302 clinical medicine, Health care, Medicine, Dementia, Terveystiede - Health care science, Homes for the Aged, Humans, 030212 general & internal medicine, Registries, Finland, Aged, Retrospective Studies, Aged, 80 and over, Terminal Care, business.industry, pattern of care, 030503 health policy & services, Research, Retrospective cohort study, care services, General Medicine, medicine.disease, Home Care Services, Long-Term Care, 3. Good health, Time of death, Nursing Homes, Hospitalization, Long-term care, Cross-Sectional Studies, ageing, care profile, Female, Health Services Research, 0305 other medical science, business, Older people, Demography
Abstract

ObjectivesThe time of death is increasingly postponed to a very high age. How this change affects the use of care services at the population level is unknown. This study analyses the care profiles of older people during their last 2 years of life, and investigates how these profiles differ for the study years 1996–1998 and 2011–2013.DesignRetrospective cross-sectional nationwide data drawn from the Care Register for Health Care, the Care Register for Social Care and the Causes of Death Register. The data included the use of hospital and long-term care services during the last 2 years of life for all those who died in 1998 and in 2013 at the age of ≥70 years in Finland.MethodsWe constructed four care profiles using two criteria: (1) number of days in round-the-clock care (vs at home) in the last 2 years of life and (2) care transitions during the last 6 months of life (ie, end-of-life care transitions).ResultsBetween the study periods, the average age at death and the number of diagnoses increased. Most older people (1998: 64.3%, 2013: 59.3%) lived at home until their last months of life (profile 2) after which they moved into hospital or long-term care facilities. This profile became less common and the profiles with a high use of care services became more common (profiles 3 and 4 together in 1998: 25.0%, in 2013: 30.9%). People with dementia, women and the oldest old were over-represented in the latter profiles. In both study periods, fewer than one in ten stayed at home for the whole last 6 months (profile 1).ConclusionsPostponement of death to a very old age may translate into more severe disability in the last months or years of life. Care systems must be prepared for longer periods of long-term care services needed at the end of life.

Published
2017

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