title: Integration and continuity of Care in health care network models for frail older adults.
abstract: A detailed review was conducted of the literature on models evaluating the effectiveness of integrated and coordinated care networks for the older population. The search made use of the following bibliographic databases: Pubmed, The Cochrane Library, LILACS, Web of Science, Scopus and SciELO. Twelve articles on five different models were included for discussion. Analysis of the literature showed that the services provided were based on primary care, including services within the home. Service users relied on the integration of primary and hospital care, day centers and in-home and social services. Care plans and case management were key elements in care continuity. This approach was shown to be effective in the studies, reducing the need for hospital care, which resulted in savings for the system. There was reduced prevalence of functional loss and improved satisfaction and quality of life on the part of service users and their families. The analysis reinforced the need for change in the approach to health care for older adults and the integration and coordination of services is an efficient way of initiating this change.
authors.affiliation: Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Renato Peixoto
authors.initials: RP
authors.lastname: Veras
authors.affiliation: Departamento de Saúde Pública, Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Célia Pereira
authors.initials: CP
authors.lastname: Caldas
authors.affiliation: Núcleo de Atenção ao Idoso, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Luciana Branco da
authors.initials: LB
authors.lastname: Motta
authors.affiliation: Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil.
authors.forename: Kenio Costa de
authors.initials: KC
authors.lastname: Lima
authors.affiliation: Núcleo de Atenção ao Idoso, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Ricardo Carreño
authors.initials: RC
authors.lastname: Siqueira
authors.affiliation: Universidade Aberta da Terceira Idade, Sub-Reitoria de Extensão e Cultura, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Renata Teixeira da Silva Vendas
authors.initials: RT
authors.lastname: Rodrigues
authors.affiliation: Universidade Aberta da Terceira Idade, Sub-Reitoria de Extensão e Cultura, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Luciana Maria Alves Martins
authors.initials: LM
authors.lastname: Santos
authors.affiliation: Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Ana Carolina Lima Cavaletti
authors.initials: AC
authors.lastname: Guerra
mesh_terms: D000368:Aged; D001938:Brazil; D003266:Continuity of Patient Care; D016330:Frail Elderly; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D011788:Quality of Life