What Can We Learn for Future Integrated Care Models in Long Term Care Facilities After the COVID-19 Emergency? Lessons From an Observational Study in Catalonia.

Introduction: The healthcare response to the COVID-19 pandemic in long term care facilities (LTCF), constitutes one of the challenges faced by governments and institutions worldwide. Our aim was to analyze the facilitators and barriers of this response, for the future integrated care model in these facilities. Methods: From a retrospective observational study, we present the experience and lessons learned of the implementation of an integrated response at the meso level in LTCF for older people and for people with physical and mental conditions in the North Metropolitan area of Barcelona, in Catalonia, during the COVID-19 pandemic. Results: We analyzed the care provided to 13,369 institutionalized people. The major facilitating points were: the adaptation of proactive care teams, the creation of a tool to improve communication with institutions, and the management of epidemiological data for planning collaboration between different actors. Main barriers were not including users and family members views in the response adaptation, and the lack of LTCF resources to respond to changing needs. Conclusions: Increasing proactivity and adapting interventions based on updated information were key to minimize infections and mortality. Improving the communication and the collaboration between actors, and people involvement in the response planning, need to be considered for the future.