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Introduction: Home Care Services (HCS) for care-dependent individuals enable their independent lives at home. We aimed to characterize users and evaluate the impact of social HCS for dependent individuals. Methods: Retrospective study including all social HCS recipients for individuals with the official recognition of dependency from Catalonia using 2018–2019 data from the Autonomy and Dependency Care System and the Catalan Health Surveillance System. Variables were social and healthcare services utilization and expenditure. HCS recipients were compared to non-recipients. Changes in services utilization and expenditure before and after HCS were estimated. Results: The 48,885 individuals who received HCS in 2019 were mostly >84 years, women, and had moderate dependency. Recipients’ prevalence was higher among low-/very-low-income individuals. HCS users had a higher morbidity burden than non-recipients with increased healthcare service utilization and associated expenditures. After HCS initiation, Telecare, day center, and most healthcare services utilization increased. Social and healthcare service-associated expenditures increased from a mean of 535 to 867 €/individual/month after HCS initiation, mostly due to HCS. Conclusions: Social HCS dependency recipients were overall very old, with moderate dependency, low-income, high morbidity, and intensive use of healthcare services. HCS is associated with increased social service-associated expenditures and modestly decreased healthcare-associated expenditures.

Background: Non-suicidal self-harming behavior is increasingly prevalent in Danish society. In somatic Emergency Departments (ED), they constitute 12,100 contacts a year. This behavior creates conflicts and (sometimes) the use of coercive measures. Experiences and research-based knowledge show treatment in the ED is challenging. Patients experience a misunderstood treatment, and nurses articulate negative attitudes such as antipathy and a stigmatizing behavior. Existing studies focus on the therapeutical treatment, such as dialectical behavior therapy where the patient is able to participate in the treatment. However, the nurses lack the knowledge of how to support these patients during a psychological crisis.Mental Health Services Region Zealand, developed a digital solution in the form of a mobile application ‘SAFE app’. The app was co-created with a multidisciplinary psychiatric team and users with lived experiences (patients and relatives). The aim of the app was to provide better and more efficient care and support. SAFE app consists of 36 calming methods. Feedback from staff members and users (relatives and people with lived experiences) was promising. However it was difficult to use the app in critical situations, where patients enter the ED.Hypothesis: When people who self-harm can use SAFE app and they can take care of their immediate needs, they will experience the treatment in ED helpful.Aims: To explore how SAFE app, a digital solution can support Treatment As Usual (TAU) in ED when people are seeking help after an episode of non-suicidal self-harm. Method: A qualitative interview study with a hermeneutical approach (Hans Georg Gadamer)was undertaken from March - April 2021. It involved two emergency departments and included all participants (n=26) who were seeking help after an episode of non-suicidal self-harm. Firstly, all participants were informed and guided in the use of SAFE app. Hereafter in-depth telephone interviews were conducted and analyzed.Results: When people enter the ED after an episode of self-harm, they described how the relationship with the professional was problematic, such as a lack of communication with the nurses, a lack of trust in the system and misunderstandings. They experienced conflict full encounters, such as when nurses possessed authoritarian behavior and they acted as guards. The SAFE app could mitigate these experiences as they found the calming methods helpful and distracting. SAFE app was perceived as a positive and caregiving supplement in TAU, which could establish a relationship with the nurses. However, they found the app to be too feminine. Discussion: The area of research is relatively young. People who engage in self-harm, experience different reasons for hurting themselves. The SAFE app can provide learning for friends, family, health-care professionals and others. The interventions must be tested in a broader population.Conclusion: Findings from this study suggest that digital solutions can supplement TAU for people with non-suicidal self-harming behavior in ED. Digital solutions can potentially improve the experiences of hospitalization, particularly in the creation of relations to the nurses. Implications for practice: Future implementation of the SAFE app will potentially reduce conflicts with nurses and provide patient-experienced quality of care.

[spa] Objetivo: Consensuar una herramienta de valoración multidimensional/geriátrica rápida (VMGR), como sistema compartido y universal de valoración multidimensional de personas con multimorbilidad, fragilidad, complejidad o situación avanzada, para todos los profesionales del sistema de salud y social de Catalun ̃a. Disen ̃o: Consenso de profesionales en tres fases, combinando sesiones presenciales con trabajo telemático. Emplazamiento: Catalun ̃a. Participantes: Se constituyó un grupo de 27 profesionales de carácter interdisciplinario repre- sentativo de los distintos ámbitos de atención. Método: Se han combinado las metodologías de Design thinking para el consenso inicial de características de la herramienta de VMGR (fase 1), con la metodología Lean Start-Up para el disen ̃o de la nueva herramienta de VMGR (fase 2), que finalmente se testeó en un grupo de pacientes (fase 3). Resultados: En la fase 1 se consensuó que la herramienta de VMGR ideal debía permitir una valoración ad hoc de las personas, ser rápida y ágil (tiempo < 10 minutos), identificar las dimen- siones alteradas mediante preguntas trigger y facilitar el diagnóstico de situación (idealmente cuantificado). En la fase 2 se elaboró el prototipo de una nueva herramienta de VMGR de 15 + dos preguntas (VIG-Express), finalmente testeada en 35 personas en la fase 3. Conclusiones: En los resultados preliminares, la herramienta VIG-Express parece facilitar una valoración multidimensional sencilla y rápida y la personalización de las intervenciones, así como una mirada única y un relato compartido entre los profesionales de los distintos ámbitos de atención. Serán necesarios más estudios para corroborar estos hallazgos. [spa] Objective: To reach a consensus on an rapid multidimensional/geriatric assessment (RMGA) tool for all health and social professionals of Catalonia as a shared and universal system to assess patients with multimorbidities, frailty, complexity or advanced conditions. Design: Three-phase consensus of professionals, combining in-person sessions with telematics. Location: Catalonia. Participants: A group of 27 interdisciplinary professionals from different care settings. Method: The Design Thinking methodology for an initial consensus on the characteristics of the RMGA tool (Phase 1) has been combined with the Lean Startup methodology to create a new RMGA tool (Phase 2), and then tested in a group of patients (Phase 3). Results: In Phase 1, a consensus was reached that the perfect RMGA tool should allow for an ad hoc assessment of patients, be fast and flexible (