Assistive Devices for Older Adults: A Longitudinal Study of Policy Effectiveness, Santiago, Chile, 2014–2016
Keywords: Aging, mobility limitation, assistive devices, activities of daily living, health care system, health care reform, quality of life, Chile
INTRODUCTION Population aging is a worldwide phenomenon. It is estimated that by 2050, one of fi ve persons will be aged ≥60 years. In Chile, 15.8% of the population is now aged ≥60 years, and this fi gure will reach 30.7% by 2050. In 2006, a national program was implemented to provide assistive devices to older adults aged ≥65 years with limited mobility or diffi culty performing activities of daily living. To date, there have been no assessments of the program’s effectiveness. OBJECTIVE Assess the effectiveness of an assistive devices policy in Chile on improving functional capacity of older adults aged ≥65 years, and benefi ciaries’ perceptions of the services received, including changes in their quality of life. METHODS This was a before–after longitudinal study. A cohort of 309 persons was recruited, consisting of patients who received care at a public hospital in Santiago, Chile during 2014–2015. They were assessed before delivery of assistive devices, then followed for seven months, with repeated evaluations made in their homes. The following indicators were measured: functional capacity (Tinetti scale and Barthel Index); changes in perceived quality of life related to use of assistive devices; and other sociodemographic, clinical and protocolcompliance variables. A longitudinal analysis of before–after progress was carried out, as well as a description of service delivery and medical followup. RESULTS Sixty-eight percent of those surveyed were women; median age was 74 years, average schooling was 6 years, and 93% had low income (monthly income <US$398). Assistive devices increased independence in activities of daily living, improved mobility and perceived quality of life, and decreased fall risk and pain. One hundred percent felt satisfi ed with the service received, 91% were trained in use of the device, and delivery deadlines were met in 83% of cases, but only 2% were followed up. One negative aspect is that the program covers only 25% of estimated need. CONCLUSIONS This assistive device program helps improve functional capacity and perceived quality of life in vulnerable patients who are able to access it. It addresses a real need and is highly valued by patients. Although delivery schedules were fulfi lled, followup care schedules were not.
|Fecha de publicación:||2019|
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