Abstract
Advanced proactive personalised telecare services in Spain have helped service users to live independently in their own homes for longer. Concern was however noted regarding potential impacts on ambulance mobilisations as time in the service, and mean age at cessation, increased. The purpose of this study was to investigate these impacts.A longitudinal study of a telecare service user population in Spain (n = 202.1 k to 247.9 k) was undertaken using anonymised operational data collected in the delivery of proactive and personalised telecare services over the period 2014–2018.For the studied population, ambulance mobilisation on a per-person/per-annum (pp/pa) basis reduced despite the increasing age profile at cessation and with the characteristics of the population at registration remaining otherwise similar over the period. The study identified the positive correlation coefficient between ambulance mobilisations and service user’s dependency levels, and marginal negative correlation in older age bands.In conclusion, the increasing age at cessation has not correlated with an increased proportion of higher dependency service users. Indeed, the share of those over 85 years in the high dependency level decreased. This indicates that the changes in the telecare service which appear to have contributed to increased time living independently may also have helped ensure those continuing to live independently remain in lower risk bands.
Highlights
Spain is one of the leading countries [1,2,3,4] in the application of proactive and personalised telecare to help support frail and vulnerable service users to live safely and independently in their own homes for longer.1 In basic form such services provide a personal emergency response management capability reacting to user or sensor triggered alarms
Contributes new insight which extends the existing research literature. This was a longitudinal study of the ambulance mobilisations of a telecare service user population over a 5-year period (2014–2018 inclusive) during which the mean age at cessation had increased by 1.3 years as set out in the introduction
As an active telecare service user population, this was subject to change over time as new service users became eligible to register for the services whilst for others the service was ceased, most frequently due to their death (43.8% of cessations over the 2014–2018 period), or transfer to residential care (25.9% of cessations over the period)
Summary
Spain is one of the leading countries [1,2,3,4] in the application of proactive and personalised telecare to help support frail and vulnerable service users to live safely and independently in their own homes for longer. In basic form such services provide a personal emergency response management capability reacting to user or sensor triggered alarms (referred to as reactive telecare). Commencing in the 1990s, Spain pioneered progressively more advanced telecare approaches to help proactively support service users’ physical and mental health conditions, as well as wider social situations such as isolation (referred to as proactive telecare) This has become more advanced over time, with more recent developments including risk assessment/ stratification to enable support to be directed most efficiently to service user needs (referred to as personalised telecare). Through the delivery of proactive and personalised telecare services, comprehensive operating and sensor-based data is necessarily collected This represents a rich dataset to enable advanced and progressively predictive analytics to further support the development of the telecare service capability, as well as supporting allied research. Tunstall Televida is one of the largest providers of proactive telecare services in Spain and, as result, has one of the largest and comprehensive datasets for analysis
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