Condition: Frailty · Dependence · Integrated Care · Sponsor: Göteborg University
Coordination and integration between care settings is essential for the quality of care of frail older patients. An active follow-up by a case manager (CM) after discharge form an acute geriatric hospital ward has the potential to bridge the gap between hospital, primary and municipality care for frail older people. This study evaluates the effects of an active follow-up by a CM in primary care after discharge from a geriatric ward, with the following research questions: Can an active follow-up by CM for frail older people discharged from an acute geriatric ward, compared to those not receiving active follow up, Maintain/increase independence in activities of daily living, self-rated health and life satisfaction? Increase satisfaction with health care? Reduce health care consumption/be cost-effective? How feasible is the intervention and the study design from the perspective of the caregivers and the older person? This is a clinical controlled study with a process evaluation. Inclusion criteria are 75 years or older, frail and admitted to a geriatric ward. This study is relevant since today's highly specialized acute care is poorly adapted to the comprehensive needs of frail older people, and exposes them to avoidable risks such as loss of functional capacities causing unnecessary care needs and decreased wellbeing. Active follow-up by a CM after discharge may be an important way to integrate the care for frail older people, after receiving in-hospital geriatric care. This c…
This description comes directly from the study's public registry record.
Theresa Westgård, PhD, Associate Professor · 18628820334 · Theresa.westgard@neuro.gu.se
Isabelle Andersson Hammar, PhD, Associate Professor · +46766185719 · Isabelle.a-h@neuro.gu.se
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| University of Gothenburg | Gothenburg, Sweden | Recruiting |
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Source record: clinicaltrials.gov/study/NCT06368674