Evidence map›Paper›PMID 29315370›Full record

ArticleAge and ageing2018

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes.

Adam L Gordon, Claire Goodman, Sue L Davies, Tom Dening, Heather Gage, Julienne Meyer, Justine Schneider, Brian Bell, Jake Jordan, Finbarr C Martin and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Age and ageing, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  6. Relationship-Centered Care for Older Adults in Long-Term Care Homes: A Scoping Review.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Adam L GordonDivision of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
Claire GoodmanCentre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK.
Sue L DaviesCentre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK.
Tom DeningInstitute of Mental Health, University of Nottingham, Nottingham, UK.
Heather GageSurrey Health Economics Centre, University of Surrey, Guildford, UK.
Julienne MeyerSchool of Health Sciences, City, University of London, London, UK.
Justine SchneiderInstitute of Mental Health, University of Nottingham, Nottingham, UK.
Brian BellDivision of Primary Care, University of Nottingham, Nottingham, UK.
Jake JordanSurrey Health Economics Centre, University of Surrey, Guildford, UK.
Finbarr C MartinDivision of Health and Social Care Research, Kings College, London, UK.
Steve IliffeCentre for Ageing Population Studies, University College, London, UK.
Clive BowmanSchool of Health Sciences, City, University of London, London, UK.
John R F GladmanDivision of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
Christina VictorCollege of Health and Life Sciences, Brunel University London, London, UK.
Andrea MayrhoferCentre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK.
Melanie HandleyCentre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK.
Maria ZubairDivision of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.

Funding

Department of Health 11/1021/02
6 · The paper itself

Abstract

introductioncare home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use.

methodsa realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners.

resultscontext-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites.

conclusionactivities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.

Indexed as

Attitude of Health PersonnelHealth Knowledge, Attitudes, PracticeDelivery of Health Care, IntegratedHealth PersonnelHealth Services for the AgedHomes for the AgedHumansNursing HomesPatient Care TeamQualitative ResearchQuality ImprovementQuality Indicators, Health CareState MedicineUnited Kingdomhealth services for the agedhomes for the agednursing homesolder peopleprimary care

Identifiers

PMID29315370
PMCPMC6014229

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.