Evaluation design of a reactivation care program to prevent functional loss in hospitalised elderly: A cohort study including a randomised controlled trial

BMC Geriatrics

Johan P Mackenbach³  Ewout W Steyerberg³  Ton JEM Bakker²  Jeroen DH van Wijngaarden¹  Anna P Nieboer¹  Paul L de Vreede³  Kirsten JE Asmus-Szepesi³ 

[1] Institute of Health Policy and Management, Erasmus University Rotterdam, the Netherlands;ARGOS zorggroep, Schiedam, the Netherlands;Erasmus University Medical Centre, Department of Public Health, Rotterdam, the Netherlands

Others  :  858278
DOI  :  10.1186/1471-2318-11-36

 received in 2011-07-12, accepted in 2011-08-03,  发布年份 2011

【 摘 要 】

Background

Elderly persons admitted to the hospital are at risk for hospital related functional loss. This evaluation aims to compare the effects of different levels of (integrated) health intervention care programs on preventing hospital related functional loss among elderly patients by comparing a new intervention program to two usual care programs.

Methods/Design

This study will include an effect, process and cost evaluation using a mixed methods design of quantitative and qualitative methods. Three hospitals in the Netherlands with different levels of integrated geriatric health care will be evaluated using a quasi-experimental study design. Data collection on outcomes will take place through a prospective cohort study, which will incorporate a nested randomised controlled trial to evaluate the effects of a stay at the centre for prevention and reactivation for patients with complex problems. The study population will consist of elderly persons (65 years or older) at risk for functional loss who are admitted to one of the three hospitals. Data is prospectively collected at time of hospital admission (T0), three months (T1), and twelve months (T2) after hospital admission. Patient and informal caregiver outcomes (e.g. health related quality of life, activities of daily living, burden of care, (re-) admission in hospital or nursing homes, mortality) as well as process measures (e.g. the cooperation and collaboration of multidisciplinary teams, patient and informal caregiver satisfaction with care) will be measured. A qualitative analysis will determine the fidelity of intervention implementation as well as provide further context and explanation for quantitative outcomes. Finally, costs will be determined from a societal viewpoint to allow for cost effectiveness calculations.

Discussion

It is anticipated that higher levels of integrated hospital health care for at risk elderly will result in prevention of loss of functioning and loss of quality of life after hospital discharge as well as in lower burden of care and higher quality of life for informal caregivers. Ultimately, the results of this study may contribute to the implementation of a national integrated health care program to prevent hospital related functional loss among elderly patients.

Trial registration

The Netherlands National Trial Register: NTR2317

【 授权许可】

   
2011 Asmus-Szepesi et al; licensee BioMed Central Ltd.

【 图 表 】

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