International Journal of Integrated Care (Aug 2019)
Early signaling and prevention of malnutrition through care integration for elderly people living at home
Abstract
Background: In the Netherlands, elderly people live longer and longer at home. Estimates show that the number of elderly people living at home will increase from 3 million (17%) in 2017 to 4,5 million (25%) in 2040. Estimates show that 15 to 25% of the elderly who receive care at home is malnourished. Causes are a reduced thirst-tingling and appetite, loneliness and bad teeth. In most cases, elderly people are not aware of becoming undernourished. Consequently physical resistance drops, resulting in an increased risk of diseases and complications. Preventing undernourishment among this population is crucial. Aims and objectives: The aim of this research is to increase the number of high-quality and meaningful life years for elderly people and thereby limiting the demand for care. For this purpose, this project aims at prevention of undernourishment of the elderly at home through a sustainable and cost-effective design of personalized preventive care with use of blockchain technology. To this end, his research combines the field of preventive care, that of blockchain technology and the field of economics. Prognostic epidemiological research of the Dutch Malnutrition Steering Group identifies predictors for imminent undernourishment amongst elderly. In this research project, these predictors are tested on feasibility in practice in close collaboration with elderly people living at home, (informal) caregivers, general practitioners, practice assistants and visiting nurses. Based on these experiences, a functional decomposition of processes and interventions is set up. To streamline data, actions, and processes, this research project applies blockchain technology. In the context of this project, several stakeholders are involved. Something like a central agency on this dossier is not available. Therefore it is essential that the stakeholders have access to a trusted technical infrastructure that enables participants to record and share relevant data in an easy and reliable way. Blockchain technology can provide this infrastructure. To determine whether this preventive care innovation is cost effective, a cost-utility analysis (CUA) is performed. This analysis is important to convince the relevant health care budget authorities to finance this preventive care innovation. In addition, a budget impact analysis (BIA) is composed. The BIA pictures the difference in expected expenditures between a scenario in which the new intervention is accepted and disseminated and the reference scenario in which that is not the case. Format: - Introduction – 15 minutes – Wil van Erp and Roelof Ettema. - Discussion on possibilities and constraints of blockchain technology in care contexts – 30 minutes discussion in small groups, followed by 10 minutes plenary wrap up – Wil van Erp, Roelof Ettema and Dennis van Kerkvoorden. - How to finance the proposed preventive care integration – 20 minutes plenary brainstorm – Wil van Erp. - Conclusion – 15 minutes – Roelof Ettema. Target audience: Health care professionals, specialized in preventive care and/or e-health technology and/or finance of (integrated) care. Learnings: After this session, the participants have knowledge of the disruptive potential of blockchain technology in the integration of care. Moreover, the participants gain new insights on how to finance innovative car integration.
Keywords
