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Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual’s needs and goals.

In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.

The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization’s needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.

The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual’s needs and goals.

Ageing is associated with multi-morbidity, polypharmacy and medication-related harm (MRH). There is limited published literature on MRH in older Egyptian adults. This study aims to determine the incidence and risk factors associated with MRH in an Egyptian cohort of older patients in the 8-weeks period after hospital discharge.

This study recruited 400 Egyptian patients, aged = ≥ 60 years from 3 hospitals in Cairo and followed them up 8 weeks after discharge using a semi-structured telephone interview to verify MRH events (type, probability, severity and preventability) and related factors.

The participants’ ages ranged from 60 to 95 years with 53% females. In the final cohort of 325 patients analyzed, MRH occurred in 99 patients (incidence of 30.5%), of which 26 MRH cases (26.2%) were probable, serious and preventable. MRH included adverse drug reactions (ADRs), non-adherence and medication errors. Multivariate regression analysis showed that non-adherence and inappropriate prescription had highly significant association with MRH (P < 0.001), history of previous ADR, living alone and presence of paid caregiver had significant association (P 0.008, 0.012, 0.02 respectively), while age, medications number, length of stay (LOS) and cognitive impairment were not significantly associated with MRH.

These findings demonstrate the magnitude of MRH in Egypt affecting almost a third of older adults after leaving the hospital. These original data could guide decision-makers to enhance older patients’ medication safety through education, quality improvement and policy.

MRH in Egyptian older adults post-hospital discharge has not been adequately reported in scientific literature.

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.

The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.

PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.

This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.

We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.

Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.

There is growing recognition that transformation of healthcare systems towards health and well-being systems requires a continuous learning process. This explorative study aims to gain insight into the experiences with and investment in these learning processes within regional partnerships for health and in what they need to enhance their learning capacity to use the learning for transformation.

17 interviews were held with programme managers, data scientists, trusted advisors and a citizen representative, all involved in the learning process on a regional level in ten Dutch regional partnerships. The interviews were inductively and thematically analysed, focusing on the experiences and perceptions underlying the learning processes.

Regional partnerships invest in learning processes by organizing interactions between different groups of stakeholders and by reflecting on specific themes or on a region-wide level. Difficulty was found in region-wide reflection and in enhancing the learning capacity within the partnerships. Further enhancing the learning capacity required: (1) Investment in (the use of) expertise for translating learning outcomes into concrete action; (2) Leadership for change, underpinned by a shared sense of urgency to learn for transformation and (3) A facilitative environment for change which is both based on facilitative system structures and a basis of trust and commitment to learn and adapt.

The study highlighted the difficulty of learning on a region-wide level and the struggle to apply this learning for transformation. It provides insights into how learning processes and learning capacity can be further improved.

Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).

The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.

Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.

This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.

The current research elucidates the role of empathy in design of artificial intelligence (AI) systems in healthcare context, through a structured literature review, analysis and synthesis of academic literature published between 1990 and 2024.

This study aims to advance the domain of empathy in AI by adopting theory constructs context method approach using the PRISMA 2020 framework.

The study presents a current state-of-the-art literature to review the connections between empathy and AI and identifying four clusters showing the emerging trajectories in the field of AI and empathy in healthcare setting.

Despite a rise in empirical research, the potential pathways enhancing AI accountability by incorporation of empathy is unclear. The research aims to contribute to the existing literature on AI and empathy in the healthcare sector by carving out four distinct clusters depicting the future research avenues.

Due to the rapid ageing of the continent's population, a significant surge in long-term care expenses for the elderly is expected across Europe in the coming years. Could a potential solution to this challenge involve the increased informal care provided by adult children? In this context, we examined a general view or moral duty of European citizens regarding whether adult children should assume responsibility for providing long-term care to the elderly.

Our multilevel analysis draws on individual-level data from the 2017 European Value Study and country-level data from various European sources encompassing participants from 21 member countries of the European Union.

The findings reveal that in nations where public long-term care services are sufficiently available and of superior quality, there is a negative sentiment towards the notion that adult children should bear the responsibility for elderly care. In total, 71% of the country-level variance in our dependent variable was explained by the availability and quality of formal long-term care in a country. Furthermore, various individual-level attributes contribute to shaping attitudes towards care-giving responsibility. We observed that women, middle-aged individuals, those without religious affiliations, those with modern gender role attitudes and non-immigrants tended to hold unfavourable attitudes towards the responsibility of adult children in long-term care provision.

There are relatively many studies on the general attitude of the population towards filial obligation. However, so far there have been very few studies available that examine the population's attitude towards the obligation of adult children to commit to their parents' long-term care. Our research explains the variation of the phenomenon in Europe with both country-level and individual-level factors.

To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.

Hospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.

Pre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.

The analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.

This study applies Garfinkel’s (1967) concept of ‘breaching experiment’ to explore the impact of COVID-19-induced disruptions on the ‘emotion management’ practices of residential care workers in the United Kingdom and Germany. It examines the influence of professional feeling rules on workers, emphasizing the prescribed importance of displaying affective, empathetic concern for residents’ health and well-being. Findings demonstrate that authenticity and adherence to professional feeling rules in relation to emotional management are not mutually exclusive. The authors underscore how adherence to professional feeling rules upholds authentic care by reinforcing a professional ethos, which acts as a cornerstone motivating residential care workers. Ultimately, the study showcases how a professional ethos substantiates altruistic motivations, guiding proficient emotion management practices among care workers. It highlights how these workers drew upon their personal understanding and experiences to determine the appropriate emotions to express while providing care for residents amid the unprecedented challenges of the pandemic.