ArticleAtencion primaria2026
[Impact of the Diagnostic and Therapeutic Assignment Model (MADiT) on the quality of care in institutionalized older adults: A quasi-experimental study].
Article in Atencion primaria, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the impact of the Diagnostic and Therapeutic Assignment Model (MADiT) on the quality of Shared Individual Intervention Plans (PIIC) and on the identification of individuals with complex chronic conditions (PCC) and advanced chronic conditions (MACA) in nursing homes.
designProspective, non-randomized intervention study with a before-after design.
settingFifteen nursing homes, of which twelve were included in the analysis.
participantsA total of 1,058 institutionalized adults aged over 65 years: 459 evaluated in 2021 (pre-intervention) and 599 in 2023 (post-intervention). Mean age: 88.7 years; 73.8% women.
interventionsA structured, continuous training program for primary care professionals and nursing home social and healthcare staff, focused on the use of the IF-VIG frailty index, PIIC preparation, and application of the MADiT model for diagnostic stratification and shared clinical decision-making.
main outcome measuresPIIC quality; identification of PCC and MACA.
resultsThirteen training sessions were delivered to 45 professionals. The proportion of high-quality PIIC increased from 0% to 55.8%, while incomplete and missing PIIC decreased to 24.2% and 20.2%, respectively (P<.001). Identification of PCC increased from 59% to 70.9%, and identification of MACA rose from 6% to 12% (P<.001).
conclusionsImplementation of the MADiT model in nursing homes was associated with a significant improvement in PIIC quality and in the identification of PCC and MACA. Its use in real-world care settings reinforces its value as a tool to structure shared approaches and optimize comprehensive planning in complex geriatric populations.
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