Incorporating community volunteers into the health care system shows promise in reducing health care usage by older adults and shifting health care from hospitals to primary care, according to new research in CMAJ (Canadian Medical Association Journal).
"We found that older adults who took part in the Health TAPESTRY program changed the way in which they used health care services," says lead author Dr. Lisa Dolovich, Department of Family Medicine, McMaster University, Hamilton, Ontario. "Encouragingly, participants had more visits to primary care with fewer [emergency department] and hospital admissions compared to those not in the program."
The Health TAPESTRY (Health Teams Advancing Patient Experience: Strengthening Quality) project combines new elements, such as using trained volunteers and electronic software, with the current health system, to support optimal aging in adults aged 70 years or older. While results from the randomized controlled trial did not affect the primary goal of the study, which was to help older adults to reach their health goals, there were other positive effects between the intervention and control groups. For example, there was an increase of 81 minutes of weekly walking time in the intervention group compared with a 120-minute decrease in the control group, and the intervention group reported higher overall levels of physical activity. The volunteers gave primary health care teams information that the health providers might not have otherwise known.
"These findings suggest that Health TAPESTRY has the potential to improve the way primary care is delivered in Canada by shifting care of individuals away from hospitals to the community and to a more proactive and preventative team-based model of care," says coauthor Dr. David Price, chair, Department of Family Medicine, McMaster University.
In a related commentary, Dr. Susan Smith, Royal College of Surgeons in Ireland, Dublin, Ireland, writes, "The results of this study suggest that the Health TAPESTRY intervention may contribute to improvements in patient care for older, community-dwelling adults. Further exploration of this model of care is warranted given the challenge for all health systems in shifting from single-condition care pathways to approaches that seek to address multimorbidity."
"Combining volunteers and primary care teamwork to support health goals and needs of older adults: a pragmatic randomized controlled trial" is published May 6, 2019.