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Table 3 Key features of the proposed intervention in elderly care

From: Healthcare professionals and managers' participation in developing an intervention: A pre-intervention study in the elderly care context

Key features of the Proposed Intervention in Elderly Care

 

Objectives:

   • Improve care for older persons with complex and multidimensional chronic conditions

 

   • Prevent unwanted institutionalization and unnecessary use of services

Clinical, collaborative and organizational means:

Strengthen primary care

 

   • Maintain the PCP as the main medical practitioner

 

   • Integrate health professionals into a multidisciplinary team

 

   • Introduce a case manager collaborating with PCPs

 

   • No translocation to secondary care

 

Coordinate primary and secondary care

 

   • Better communication

 

   • Access to geriatric expertise for PCP (a community-based geriatrician)

 

   • Direct access to hospitalization

 

No change in funding mechanisms