Istituzioni Don Carlo Botta

Bergamo, Italy

Istituzioni Don Carlo Botta

Bergamo, Italy
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The increased demand to care that originates from demographic changes called in Italy a rapid development in Nursing Home with particular emergency the problem of programme the welfare response. It is essential the development of a classification system able to describe the stratification of the case mix on the basis of the care requirements, allowing a remuneration in function of the complexity care. Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini-Mental State Examination on the basis of three indicators (mobility, cognition, comorbidity) is evaluated in eight classes of frailty. However, it is not any research project was published in order to assess the agreement between SOSIA classification and other measuring instruments. Although various methods exist by which researchers have attempted to measure the need for nursing care, there is no nationally accepted system for determining the total amount of registered nursing resources required by residents in long-term care. The aim of this study was to evaluate the correlation between SOSIA and filing systems widely used, such as the degree of Barthel disability rating scale, the Mini-Mental State Examination to offer care appropriate for the casemix. Only the higher complexity care has classified in the first two classes, while the remaining levels has categorized in the lowest paid. Misclassification therefore induces an underestimation of the real care needs and, consequently, inadequate remuneration.


Vigano G.,Istituzioni Don Carlo Botta | Squassoni N.,Istituzioni Don Carlo Botta | Pancaldi L.,Istituzioni Don Carlo Botta | Evangelisti E.,Istituzioni Don Carlo Botta | Balzarolo C.,Istituzioni Don Carlo Botta
Giornale di Gerontologia | Year: 2012

Obiectives. To evaluate the feasibility of rehabilitation treatment using Wii gaming system by Nintendo® in nursing home residents affected by motor and mild to moderate cognitive impairment. Methods. Pilot study in three groups of subjects (15 patients with previous stroke with motor disability, 15 patients with previous physical impairment due to arm or leg fractures, 15 patients with mild to moderate cognitive impairment with or without motor disability). They underwent a 4 weeks treatment rehabilitation cycle, 3 times a week for 15 minutes, using the Wii gaming system. Before and after rehabilitation cycle Barthel Index, Physical Performance Test (PPT) and Mini Mental State Examination Test were performed. Three control groups (n = 15 each) were also enrolled. Finally, a subgroup of 25 patients treated using Wii gaming system was administered Geriatric Depression Scale before and after the rehabilitation cycle. Results. The rehabilitation exercises using Wii gaming system (Wii Sports game) were feasible and very appreciated by all the subjects involved into this pilot study. After the rehabilitation cycle, a mild improvement in PPT was observed but it was not statistically significant. In contrast, the value of Geriatric Depression Scale was significantly improved by using Wii gaming system (p < 0.0032). Conclusions. The results of this study are consistent with the finding that the use of video games by Nintendo® Wii is effective at improving physical performance in nursing home residents. An antidepressive effect was also observed.

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