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Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

To assess the effectiveness of an integrated care program for post-acute care of stroke patients, the return home program (RHP program), deployed in Barcelona (North-East Spain) between 2016 and 2017 in a context of health and social care information systems integration.

The RHP program was built around an electronic record that integrated health and social care information (with an agreement for coordinated access by all stakeholders) and an operational re-design of the care pathways, which started upon hospital admission instead of discharge. The health outcomes and resource use of the RHP program participants were compared with a population-based matched control group built from central healthcare records of routine care data.

The study included 92 stroke patients attended within the RHP program and the patients' matched controls. Patients in the intervention group received domiciliary care service, home rehabilitation, and telecare significantly earlier than the matched controls. Within the first two years after the stroke episode, recipients of the RHP program were less frequently institutionalized in a long-term care facility (5 vs 15%). The use of primary care services, non-emergency transport, and telecare services were more frequent in the RHP group.

The authors' analysis shows that an integrated care program can effectively promote and accelerate delivery of key domiciliary care services, reducing institutionalization of stroke patients in the mid-term. The integration of health and social care information allows not only a better coordination among professionals (thus avoiding redundant assessments) but also to monitor health and resource use outcomes of care delivery.

This paper aims to describe and explain women's labor participation in the public sector, particularly at the local level. The paper analyses the representation of women employees in the public sector through a case study of a city council in a mid-sized Spanish city. The authors delve into the extent of gender labor discrimination in public administration, exploring a diversity of situations, experiences, and perceptions of women workers in female, neutral, and male-dominated areas in the local administration.

The authors have applied a combined methodology of quantitative analysis based on an exhaustive analysis of the list of job posts, and qualitative analysis from the narratives of women workers in biographical interviews, in women-dominated, neutral and male-dominated areas.

The authors conclude by providing a clear description of women's representation in local administration. Despite the institutional efforts in applying gender equality norms and public policies in administration, employment and labor market, this article shows the persistent inequality in employment within the administration. The paper demonstrates that public administrations can be seen as gender regimes that tend to reproduce inequality by formal and informal dynamics. This inequality gender reproduction in a supposedly gender-neutral administration reflects discrimination in a labor market. The paper details phenomena relating to horizontal occupational segregation, glass ceilings, sticky floors, and the undervaluing of women's work, among other phenomena.

The administration should consider two essential factors that endanger gender equality: (1) the demonstrated regression of gender mainstreaming and the effects on women's employment as a consequence of the crisis, and (2) neoliberal governments and extreme right-wing parties (or neoliberal governments and extreme right-wing parties' support, as is the case with the current Andalusian regional government), whose agenda includes the fight against what neoliberal governments and extreme right-wing parties call “gender ideology”.

The gap between the effectiveness of gender legislation and actual working practices within the administration has been highlighted. This fact should be a wake-up call for the administrations to strictly comply with gender legislation, given that local administrations are the closest to the citizens. Future research should focus on changes to detect any regression and to prevent losing the improvements already achieved, which can still be very much strengthened.

This article helps to fill the gap in the literature on gender discrimination in the labor market, which often omits the public sector, especially in local administration, which is the closest administrative structure to citizenship respecting public policies. The article contributes to highlighting the need for an egalitarian labor market in order to achieve optimal performance, commitment and efficiency in egalitarian labor relations in local administration.