Proactive healthcare for frail elderly persons: study protocol for a prospective controlled primary care intervention in Sweden.
Aged
Aged, 80 and over
Ambulatory Care
/ economics
Cost-Benefit Analysis
Female
Frail Elderly
Frailty
/ economics
Health Care Costs
Health Policy
Hospitalization
/ economics
House Calls
Humans
Length of Stay
/ economics
Male
Mortality
Primary Health Care
/ methods
Public Policy
Quality of Life
Social Support
Sweden
Telephone
care frail elderly
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
22 05 2019
22 05 2019
Historique:
entrez:
25
5
2019
pubmed:
28
5
2019
medline:
30
5
2020
Statut:
epublish
Résumé
The provision of healthcare services is not dedicated to promoting maintenance of function and does not target frail older persons at high risk of the main causes of morbidity and mortality. The aim of this study is to evaluate the effects of a proactive medical and social intervention in comparison with conventional care on a group of persons aged 75 and older selected by statistical prediction. In a pragmatic multicentre primary care setting (n=1600), a prediction model to find elderly (75+) persons at high risk of complex medical care or hospitalisation is used, followed by proactive medical and social care, in comparison with usual care. The study started in April 2017 with a run-in period until December 2017, followed by a 2-year continued intervention phase that will continue until the end of December 2019. The intervention includes several tools (multiprofessional team for rehabilitation, social support, medical care home visits and telephone support). Primary outcome measures are healthcare cost, number of hospital care episodes, hospital care days and mortality. Secondary outcome measures are number of outpatient visits, cost of social care and informal care, number of prescribed drugs, health-related quality of life, cost-effectiveness, sense of security, functional status and ability. We also study the care of elderly persons in a broader sense, by covering the perspectives of the patients, the professional staff and the management, and on a political level, by using semistructured interviews, qualitative methods and a questionnaire. Approved by the regional ethical review board in Linköping (Dnr 2016/347-31). The results will be presented in scientific journals and scientific meetings during 2019-2022 and are planned to be used for the development of future care models. NCT03180606.
Identifiants
pubmed: 31122995
pii: bmjopen-2018-027847
doi: 10.1136/bmjopen-2018-027847
pmc: PMC6538001
doi:
Banques de données
ClinicalTrials.gov
['NCT03180606']
Types de publication
Journal Article
Pragmatic Clinical Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e027847Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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