TY - JOUR
T1 - Embrace, a model for integrated elderly care
T2 - study protocol of a randomized controlled trial on the effectiveness regarding patient outcomes, service use, costs, and quality of care
AU - Spoorenberg, Sophie L W
AU - Uittenbroek, Ronald J
AU - Middel, Berrie
AU - Kremer, Berry P H
AU - Reijneveld, Sijmen A
AU - Wynia, Klaske
N1 - Trial registration: The Netherlands National Trial Register NTR3039
PY - 2013/6/19
Y1 - 2013/6/19
N2 - Background: Ongoing growth in health care expenditures and changing patterns in the demand for health care challenge societies worldwide. The Chronic Care Model (CCM), combined with classification for care needs based on Kaiser Permanente (KP) Triangle, may offer a suitable framework for change. The aim of the present study is to investigate the effectiveness of Embrace, a population-based model for integrated elderly care, regarding patient outcomes, service use, costs, and quality of care.Methods/Design: The CCM and the KP Triangle were translated to the Dutch setting and adapted to the full elderly population living in the community. A randomized controlled trial with balanced allocation was designed to test the effectiveness of Embrace. Eligible elderly persons are 75 years and older and enrolled with one of the participating general practitioner practices. Based on scores on the INTERMED-Elderly Self-Assessment and Groningen Frailty Indicator, participants will be stratified into one of three strata: (A) robust; (B) frail; and (C) complex care needs. Next, participants will be randomized per stratum to Embrace or care as usual. Embrace encompasses an Elderly Care Team per general practitioner practice, an Electronic Elderly Record System, decision support instruments, and a self-management support and prevention program - combined with care and support intensity levels increasing from stratum A to stratum C. Primary outcome variables are patient outcomes, service use, costs, and quality of care. Data will be collected at baseline, twelve months after starting date, and during the intervention period.Discussion: This study could provide evidence for the effectiveness of Embrace.
AB - Background: Ongoing growth in health care expenditures and changing patterns in the demand for health care challenge societies worldwide. The Chronic Care Model (CCM), combined with classification for care needs based on Kaiser Permanente (KP) Triangle, may offer a suitable framework for change. The aim of the present study is to investigate the effectiveness of Embrace, a population-based model for integrated elderly care, regarding patient outcomes, service use, costs, and quality of care.Methods/Design: The CCM and the KP Triangle were translated to the Dutch setting and adapted to the full elderly population living in the community. A randomized controlled trial with balanced allocation was designed to test the effectiveness of Embrace. Eligible elderly persons are 75 years and older and enrolled with one of the participating general practitioner practices. Based on scores on the INTERMED-Elderly Self-Assessment and Groningen Frailty Indicator, participants will be stratified into one of three strata: (A) robust; (B) frail; and (C) complex care needs. Next, participants will be randomized per stratum to Embrace or care as usual. Embrace encompasses an Elderly Care Team per general practitioner practice, an Electronic Elderly Record System, decision support instruments, and a self-management support and prevention program - combined with care and support intensity levels increasing from stratum A to stratum C. Primary outcome variables are patient outcomes, service use, costs, and quality of care. Data will be collected at baseline, twelve months after starting date, and during the intervention period.Discussion: This study could provide evidence for the effectiveness of Embrace.
KW - Integrated health care systems
KW - Population-based care
KW - Chronic Care Model
KW - Ageing
KW - Chronic disease
KW - Patient outcomes
KW - Quality of care
KW - Cost effectiveness
KW - CHRONIC ILLNESS CARE
KW - GRONINGEN FRAILTY INDICATOR
KW - MULTIPLE CHRONIC CONDITIONS
KW - IMPROVING PRIMARY-CARE
KW - GUIDED CARE
KW - HEALTH-CARE
KW - GENERAL-PRACTICE
KW - OLDER PERSONS
KW - SELF-REPORT
KW - MANAGEMENT
U2 - 10.1186/1471-2318-13-62
DO - 10.1186/1471-2318-13-62
M3 - Article
C2 - 23782932
SN - 1471-2318
VL - 13
JO - BMC Geriatrics
JF - BMC Geriatrics
M1 - 62
ER -