Implementation and impact of the World Health Organization integrated care for older people (ICOPE) program in China: a randomised controlled trial

医学 随机对照试验 干预(咨询) 老年学 医疗保健 综合护理 活力 护理部 神学 经济增长 哲学 外科 经济
作者
Ninie Yan Wang,Xiaohong Liu,Xiangrong Kong,Yuka Sumi,Jagadish K. Chhetri,Linlin Hu,Minglei Zhu,Lin Kang,Zhen Liang,John W. Ellis,Leiyu Shi
出处
期刊:Age and Ageing [Oxford University Press]
卷期号:53 (1) 被引量:16
标识
DOI:10.1093/ageing/afad249
摘要

Abstract Background Fragmentation of services increases health and social care burden as people live longer with higher prevalence of diseases, frailty and dependency. Local evidence for implementing person-centred integrated care is urgently needed to advance practice and policies to achieve healthy ageing. Objective To test the feasibility and impact of World Health Organization's (WHO) Integrated Care for Older People (ICOPE) approach in China. Design A randomised controlled trial examining the feasibility of implementing ICOPE approach, evaluating its impact on health outcomes and health resource utilisation. Setting Primary care setting in urban and suburban communities of Chaoyang District, Beijing, China. Subjects Community-dwelling older adults screened as at-risk of functional declines and randomised into intervention (537) and control (1611) groups between September 2020 and February 2021. Methods A 6-month intervention program following WHO's ICOPE care pathways implemented by integrated care managers compared to standard available care. Results After 1 to 1 propensity score matching, participants in intervention and control groups (totally 938) had comparable baseline characteristics, demonstrated feasibility of implementing ICOPE with satisfaction by participants (97–99%) and providers (92–93%). All outcomes showed improvements after a 6-month intervention, while statistically significant least-squares mean differences (control-intervention) in vitality (Mini-Nutritional Assessment Short Form to measure vitality, −0.21, 95% CI, −0.40–0.02), mobility (Short Physical Performance Battery to measure mobility, −0.29, 95% CI, −0.44–0.14) and psychological health (Geriatric Depression Scale five items to measure psychological health, 0.09, 95% CI, 0.03–0.14) were observed (P < 0.05). Conclusions It is feasible to localise and implement WHO’s ICOPE approach in regions with fragmented resources such as China. Preliminary evidence supports its acceptance among key stakeholders and impact on health outcomes.
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