Dynamics of satisfaction and health data of patients over 65 years old after integration of care assistants into mobile medical teams

In the Russian Federation, a pilot initiative is currently underway to establish a long-term care system for elderly individuals and persons with disabilities. A primary objective of this initiative is the integration of medical and social care services. Objective. To evaluate changes in patient satisfaction, health metrics, and primary healthcare admissions among patients aged 65 and older who require long-term care following the implementation of a model integrating care assistants into mobile medical teams. Materials and methods. A prospective cohort study was conducted employing a «before-and-after» design. A total of 128 patients (64% female) aged 65 years and older who required long-term care were enrolled. The control period, characterized by retrospective data collection, spanned 12 months (November 2023 to November 2024). The intervention period lasted 15 months (December 2024 to March 2026), during which 14 specifically trained care assistants were incorporated into the mobile teams’ operations. The primary outcome measured was patient satisfaction, assessed using a 5-point Likert scale. Secondary outcomes included the frequency of emergency hospital admissions, EMS (Emergency Medical Services) calls, and the need for medical care at home, as well as the incidence of falls and pressure ulcers per 100 patients annually. Results. The median age of participants was 78 years. Throughout the observation period, 124 individuals completed the full study protocol. Patient satisfaction increased significantly from 3.08±0.5 to 4.20±0.4 points (p<0.001). Furthermore, the frequency of emergency hospitalizations decreased from 44.8 to 31.2 per 100 patients annually (p=0.012); EMS calls reduced from 18.6 to 11.3 (p=0.008); the requirement for home medical care visits reduced from 77.4 to 48.1 (p<0.001); instances of falls decreased from 5.2 to 3.1; and the prevalence of pressure ulcers among low-mobility patients decreased from 12.8% to 6.4%. These findings align with international research regarding the efficacy of integrated care models for the elderly. The observed reduction in adverse events and enhanced patient satisfaction are likely attributable to regular monitoring and caregivers’ prompt identification of health deterioration. Noteworthy limitations of the study include its before-and-after design and single-center focus. Conclusions. The incorporation of care assistants into mobile medical teams significantly enhances patient satisfaction among older adults. Additionally, it improves critical indicators within the long-term care system, rendering this model suitable for implementation across other medical organizations.