Tele-care and tele-alarms for the elderly: preliminary experiences in Mexico

Giraldo-Rodríguez, Liliana; Torres-Castro, Sara; Martínez-Ramírez, David; Gutiérrez-Robledo, Luis Miguel; Pérez-Cuevas, Ricardo

doi:10.1590/S0034-8910.2013047004574

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Original Articles • Rev. Saúde Pública 47 (04) • Aug 2013 • https://doi.org/10.1590/S0034-8910.2013047004574 copy

Tele-care and tele-alarms for the elderly: preliminary experiences in Mexico

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

: To analyze the effect of a pilot program of tele-assistance and tele-alarms on the elderly’s self-perception of health status and to identify the satisfaction with and acceptance of the program.

METHODS

: Cross-sectional study that included interviews with 378 elderly individuals, 294 caretakers/relatives and 53 health care professionals. The program was run in Mexico City in 2010. The variables were socio-demographic characteristics, self-rated health, satisfaction and acceptance of the program. The information was gathered through a standardized questionnaire. The statistical analysis included descriptive analysis and nonparametric tests.

RESULTS

: Significant effects on self-perception of health were observed, 6.17 (SD 17.9 p < 0.05) points above the average. The program was well received and accepted by the elderly, family caregivers and health professionals.

CONCLUSIONS

: The program helps to maintain or improve quality of life, allows preventive care and is an ideal means of providing psychosocial support to the elderly.

Aged; Remote Consultation, utilization; Patient Acceptance of Health Care; Continuity of Patient Care; Home Nursing; Health Services Research

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

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[1] Correspondence
: Ricardo Pérez-Cuevas Banco Inter Americano de Desarrollo Paseo de la Reforma 222 piso 11 Colonia Juárez México Distrito Federal 06600 México E-mail: rperez@iadb.org

Variables	Elderly individual		Caregiver/relative

	Total	%	Total	%

Knowledge of and use of the program
Awareness of the services provided by the program
Ambulance	185	48.9	150	51.0
Guidance	35	9.3	42	14.3
Emergency care	85	22.5	60	20.4
Psychological care	4	1.1	8	2.7
Other (calls to relatives)	18	4.8	14	4.8
Don’t know	51	13.5	20	6.8
Use of the alarm button	183	48.4	77	26.2
Reasons for pressing the alarm button (n = 183) ^a (n = 77) ^b
Emergency	31	16.9	31	40.3
Illness	15	8.2	5	6.5
Request information	12	6.6	6	7.8
Check it works	25	13.7	11	14.3
By mistake	53	29.0	10	13.0
To talk	26	14.2	6	7.8
Other	17	9.3	7	9.1
No answer	4	2.2	1	1.3
Received calls from the operator	365	96.5	NE	NE
Reasons for receiving the call (n = 365) ^a
Monitoring illness or treatment	98	26.8	NE	NE
Reminder of appointments	15	4.1	NE	NE
Reminder to take medication	15	4.1	NE	NE
Check button is working	112	30.7	NE	NE
To provide information about the service	14	3.8	NE	NE
Congratulations for some special occasion	54	14.8	NE	NE
Other	57	15.6	NE	NE

Satisfaction and acceptance

Operators response helped solve the problem
Yes	309	81.7	253	86.1
No	23	6.1	12	4.1
No answer	46	12.2	29	9.9
Treatment received from the operator was
Good	361	95.5	282	95.9
Regular	6	1.6	2	0.7
Bad	4	1.1	1	0.3
No answer	7	1.9	9	3.1
Do you consider the tele-care service to have improved your quality of life ^c
Yes	298	78.8	274	93.2
No	70	18.5	11	3.7
No answer	10	2.6	9	3.1
The tele-care program helped you to feel less dependent or more dependent on your relatives ^d
Less	121	32.0	62	21.1
The same	208	55.0	208	70.7
More	46	12.2	20	6.8
No response	3	0.8	4	1.4
The tele-care program helped you to have more or less peace of mind
Less	2	0.5	12	4.1
The same	113	29.9	29	9.9
More	260	68.8	249	84.7
No response	3	0.8	4	1.4
Would you rate the care received from the tele-care service as
Good	341	90.2	271	92.2
Regular	13	3.4	7	2.4
Bad	9	2.4	6	2,0
No answer	15	4.0	10	3,4
In general, how would you rate the tele-care services
Good	353	93.4	284	96,6
Regular	11	2.9	4	1,4
Bad	7	1.9	3	1,0
No answer	7	1.9	3	1,0
Would you recommend this program and do you think all elderly individuals should have access to it?
Yes	363	96,0	287	97,6
No	6	1,6	3	1,0
No answer	9	2,4	4	1,4

Perception of the health care professionals (n = 53) of the TATA pilot program

	Total	%
Are you aware of the tele-care pilot program and the services
Yes	48	90.6
No	5	9.4
Have you observed changes in the health of those patients taking part in the tele-care program
Yes	22	41.5
No	24	45.3
Don’t know/No answer	7	13.2
Have you observed changes in the health of those patients taking part in the tele-care program
Yes	22	41.5
No	24	45.3
Don’t know/No answer	7	13.2
Do you perceive the health of the patients taking part in the tele-care program to be
Bad	6	11.3
Regular	8	15.1
Good	33	62.3
Don’t know/No answer	6	11.3
Medical prescriptions for patients taking part in the tele-care program have
Increased	2	3.8
Decreased	10	18.9
Remained the same	41	77.4
Demand for health care services by patients taking part in the tele-care program has
Increased	10	18.9
Decreased	13	24.5
Remained the same	20	37.7
Don’t know/No answer	10	18.9
Do you consider this program to be valuable in monitoring and caring for elderly patients?
Yes	50	94.3
No	3	5.7
Do you think this program should be extended to all elderly patients in the IMSS?
Yes	49	92.5
No	4	7.5
How would you rate the services provided by the tele-care program?
Bad	5	9.4
Regular	7	13.2
Good	41	77.4