Bibliografia

1 – Harrison JK, Walesby KE, Hamilton L, Armstrong C, Starr JM, Reynish EL, MacLullich AMJ, Quinn TJ, Shenkin SD Predicting discharge to institutional long-term care following acute hospitalisation: a systematic review and meta-analysis. Age Ageing 2017 Apr 21:1-12.

2 – Sacks GD, Lawson EH, Dawes AJ, Gibbons MM, Zingmond DS, Ko CY Which Patients Require More Care after Hospital Discharge? An Analysis of Post-Acute Care Use among Elderly Patients Undergoing Elective Surgery. J Am Coll Surg. 2015 Jun;220(6):1113-1121

3 – Iorini G, Pandini S, De Matthaeis A, Seresini M, Dragoni R, Sfogliarini R. Intermediate care as a means of improving mental status in post-acute elderly patients. Aging Clin Exp Res. 2013 Jun;25(3):337-41

4 – Colprim D, Inzitari M Incidence and risk factors for unplanned transfers to acute general hospitals from an intermediate care and rehabilitation geriatric facility. J Am Med Dir Assoc. 2014;15(9):687

5 – Pérez LM, Inzitari M, Roqué M, Duarte E, Vallés E, Rodó M, Gallofré M Change in cognitive performance is associated with functional recovery during post-acute stroke rehabilitation: a multi-centric study from intermediate care geriatric rehabilitation units of Catalonia. Neurol Sci. 2015; 36(10):1875-80.

6 – Pérez LM, Inzitari M, Quinn TJ, Montaner J, Gavaldà R, Duarte E, Coll-Planas L, Cerdà M, Santaeugenia S, Closa C, Gallofré M. Rehabilitation Profiles of Older Adult Stroke Survivors Admitted to Intermediate Care Units: A Multi-Centre Study. PLoS One. 2016;11(11)

7 – Timmer AJ, Unsworth CA, Taylor NF. Rehabilitation interventions with deconditioned older adults following an acute hospital admission: a systematic review. Clin Rehabil. 2014; 28(11):1078-86.

8 – Courtney MD, Edwards HE, Chang AM, Parker AW, Finlayson K, Hamilton K A randomised controlled trial to prevent hospital readmissions and loss of functional ability in high risk older adults: a study protocol. BMC Health Serv Rev.2011;11:202.

9 – Buurman BM, Parlevliet JL, van Deelen BA, de Haan RJ, de Rooij Se. A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: the Transitional Care Bridge BMC Health Serv res 2010 ;10:296.

10 – Etman A, Kamphuis CB, Pierik FH, Burdorf A, Van Lenthe FJ. Residential area characteristics and disabilities among Dutch community-dwelling older adults. Int J Health Geogr.2016 Nov 15;15(1):42.

11 – Røsstad T, Salvesen Ø, Steinsbekk A, Grimsmo A, Sletvold O, Garåsen H. Generic care pathway for elderly patients in need of home care services after discharge from hospital: a cluster randomised controlled trial. BMC Health Serv Res. 2017 ;17(1):275

12 – Suijker JJ, Buurman BM, ter Riet G, van Rijn M, de Haan RJ, de Rooij SE, Moll van Charante EP. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial. BMC Health Serv Res. 2012 ;12:85.

13 – Bölenius K, Lämås K, Sandman PO, Edvardsson D Effects and meanings of a person-centred and health-promoting intervention in home care services – a study protocol of a non-randomised controlled trial. BMC Geriatr. 2017 ;17(1):57.

14 – Cochrane A, Furlong M, McGilloway S, Molloy DW, Stevenson M, Donnelly M. Time-limited home-care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database Syst Rev. 2016 ;10

15 – Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N, Omar RZ, Katona C, Cooper C. A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technol Assess. 2014; 18(39):1-226

16 – Mondor L, Maxwell CJ, Hogan DB, Bronskill SE, Gruneir A, Lane NE, Wodchis WP. Multimorbidity and healthcare utilization among home care clients with dementia in Ontario, Canada: A retrospective analysis of a population-based cohort. PLoS Med. 2017;14(3)

17 – Health Quality Ontario In-home care for optimizing chronic disease management in the community: an evidence-based analysis. Ont Health Technol Assess Ser. 2013;13(5):1-65.

18 – Nunes BP, Flores TR, Mielke GI, Thumé E, Facchini LA. Multimorbidity and mortality in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr. 2016;67:130-8.

19 – Smith SM, Wallace E, O’Dowd T, Fortin M. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database Syst Rev. 2016;3

20 – Naughton BJ, Saltzman S, Priore R, Reedy K, Mylotte JM. Using admission characteristics to predict return to the community from a post-acute geriatric evaluation and management unit. J Am Geriatr Soc. 1999;47(9):1100-4.

21 – Harvey P, Storer M,Berlowitz DJ,Jackson B, Hutchinson A Lim WK. Feasibility and impact of a post-discharge geriatric evaluation and management service for patients from residential care: the Residential Care Intervention Program in the Elderly (RECIPE). BMC Geriatr. 2014; 14:48

22 – Gloth FM 3rd, Gloth MJ. A comparative effectiveness trial between a post-acute care hospitalist model and a community-based physician model of nursing home care. J Am Med Dir Assoc. 2011;12(5):384-6

23 – Sackley CM, Walker MF, Burton CR, Watkins CL, Mant J, Roalfe AK, Wheatley K, Sheehan B, Sharp L, Stant KE, Fletcher-Smith J, Steel K, Barton GR, Irvine L, Peryer G. An Occupational Therapy intervention for residents with stroke-related disabilities in UK Care Homes (OTCH): cluster randomised controlled trial with economic evaluation. Health Technol Assess. 2016; 20(15):1-138

24 – Richards CL Jr, Darradji M, Weinberg A, Ouslander JG. Antimicrobial use in post-acute care: a retrospective descriptive analysis in seven long-term care facilities in Georgia. J Am Med Dir Assoc. 2005; 6(2):109-12.

25 – Ruth S Martin, Barbara J Hayes, Anastasia Hutchinson, Paul Yates, and Wen Kwang Lim Implementation of ‘Goals of Patient Care’ medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial. BMJ Open. 2017; 7(3)

26 – Anastasia F. Hutchinson, Marnie Graco, Tshepo Mokuedi Rasekaba, Sumit Parikh, David John Berlowitz and Wen Kwang Lim. Relationship between health-related quality of life, comorbidities and acute health care utilisation, in adults with chronic conditions. Health Qual Life Outcomes. 2015; 13: 69.

27 – Stuart Howell, Michael Coory, Jennifer Martin, and Stephen Duckett Using routine inpatient data to identify patients at risk of hospital readmission. BMC Health Serv Res. 2009; 9: 96.

28 – John Billings, Jennifer Dixon, Tod Mijanovich, David Wennberg. Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients. BMJ. 2006 Aug 12; 333(7563): 327.

29 – Lyon C. Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented? Int J Evid Based Healthc. 2007 Dec;5(4):450-7

30 – Wickson-Griffiths A, Kaasalainen S, Ploeg J, McAiney C. A review of advance care planning programs in long-term care homes: are they dementia friendly? Nurs Res Pract. 2014;2014

31 – Molloy DW, Guyatt GH, Russo R, Goeree R, O’Brien BJ, Bédard M, Willan A, Watson J, Patterson C, Harrison C, Standish T, Strang D, Darzins PJ, Smith S, Dubois S. Systematic implementation of an advance directive program in nursing homes: a randomized controlled trial. JAMA. 2000 Mar 15;283(11):1437-44.

32 – Happ MB, Capezuti E, Strumpf NE, Wagner L, Cunningham S, Evans L, Maislin G. Advance care planning and end-of-life care for hospitalized nursing home residents. J Am Geriatr Soc. 2002 May;50(5):829-35.

33 – Martin RS, Hayes B, Gregorevic K, Lim WK. The Effects of Advance Care Planning Interventions on Nursing Home Residents: A Systematic Review. J Am Med Dir Assoc. 2016 Apr 1;17(4):284-93

34 – Hoek JF, Ribbe MW, Hertogh CM, van der Vleuten CP. The role of the specialist physician in nursing homes: the Netherlands’ experience. Int J Geriatr Psychiatry. 2003 Mar;18(3):244-9.

35 – Intrator O, Zinn J, Mor V. Nursing home characteristics and potentially preventable hospitalizations of long-stay residents. J Am Geriatr Soc. 2004 Oct;52(10):1730-6.

36 – Molloy DW, Guyatt GH, Russo R, Goeree R, O’Brien BJ, Bédard M, Willan A, Watson J, Patterson C, Harrison C, Standish T, Strang D, Darzins PJ, Smith S, Dubois S. Systematic implementation of an advance directive program in nursing homes: a randomized controlled trial. JAMA. 2000 Mar 15;283(11):1437-44.

37 – Hutt E, Ecord M, Eilertsen TB, Frederickson E, Kramer AM. See comment in PubMed Commons below Precipitants of emergency room visits and acute hospitalization in short-stay medicare nursing home residents. J Am Geriatr Soc. 2002 Feb;50(2):223-9.

38 – Vincent Mor, Orna Intrator, Zhanlian Feng, David C. Grabowski The Revolving Door of Rehospitalization From Skilled Nursing Facilities Health Aff (Millwood). 2010; 29(1): 57–64.

39 – Finucane PM, Wundke R, Whitehead C, Williamson L, Baggoley CJ. Profile of people referred to an emergency department from residential care. Aust N Z J Med. 1999 Aug;29(4):494-9.