Integrated care for frail elderly compared to usual care: a study protocol of a quasi-experiment on the effects on the frail elderly, their caregivers, health professionals and health care costs

BMC Geriatrics

Study Protocol

Benjamin Janse¹  Wilhelmina Mijntje Looman¹  Isabelle Natalina Fabbricotti¹  Jeroen David Hendrikus van Wijngaarden¹  Ruben de Kuijper²  Auktje Reiffers³ 

[1] Erasmus University Rotterdam, Institute of Health Policy and Management, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands;Huisartsenpraktijk Arnemuiden, Prins Bernhardstraat 2, 4341, Arnemuiden, EZ, The Netherlands;Walcherse Huisartsen Coöperatie, Adriaen Coortestraat 61, 4336, Middelburg, DM, The Netherlands;

关键词: Integrated care;    Frailty;    Vulnerable elderly;    Prevention;    Primary care;    Quasi-experimental design;    Effectiveness elderly care;    Caregiver;    Health professionals;   

DOI  :  10.1186/1471-2318-13-31

 received in 2013-03-15, accepted in 2013-04-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundFrail elderly persons living at home are at risk for mental, psychological, and physical deterioration. These problems often remain undetected. If care is given, it lacks the quality and continuity required for their multiple and changing problems. The aim of this project is to improve the quality and efficacy of care given to frail elderly living independently by implementing and evaluating a preventive integrated care model for the frail elderly.Methods/designThe design is quasi-experimental. Effects will be measured by conducting a before and after study with control group. The experimental group will consist of 220 elderly of 8 GPs (General Practitioners) who will provide care according to the integrated model (The Walcheren Integrated Care Model). The control group will consist of 220 elderly of 6 GPs who will give care as usual. The study will include an evaluation of process and outcome measures for the frail elderly, their caregivers and health professionals as well as a cost-effectiveness analysis. A concurrent mixed methods design will be used. The study population will consist of elderly 75 years or older who live independently and score a 4 or higher on the Groningen Frailty Indicator, their caregivers and health professionals. Data will be collected prospectively at three points in time: T0, T1 (3 months after inclusion), and T2 (12 months after inclusion). Similarities between the two groups and changes over time will be assessed with t-tests and chi-square tests. For each measure regression analyses will be performed with the T2-score as the dependent variable and the T0-score, the research group and demographic variables as independent variables.DiscussionA potential obstacle for this study will be the willingness of the elderly and their caregivers to participate. To increase willingness, the request to participate will be sent via the elders’ own GP. Interviewers will be from their local region and gifts will be given. A successful implementation of the integrated model is also necessary. The involved parties are members of a steering group and have contractually committed themselves to the project.Trial registrationCurrent Controlled Trials ISRCTN05748494

【 授权许可】

CC BY   
© Fabbricotti et al.; licensee BioMed Central Ltd. 2013