Incremental Cost-effectiveness Ratio, Overall Functioning
Conditions
Keywords
frailty, frail elders, multicomponent intervention, overall functioning, cost-effectiveness, integrated care, primary care, community dwelling
Brief summary
The purpose of this study is to investigate the effect of the CareWell-programme on overall functioning of community-dwelling frail elderly persons. Furthermore, the total costs and the cost-effectiveness of the CareWell-programme, in comparison with regular medical care, will be studied.
Interventions
OTHERThe CareWell programme
The CareWell programme contains the following components: * multidisciplinary primary care teams * working with proactive care plans integrating cure, care and welfare * advanced care planning (e.g. recording limitations of treatment, non-resuscitation decisions) * medication review * case-management * guidelines for consultation of in-hospital geriatric experts * guidelines for transfers from primary care to home-based facilities and hospital and back * practice guidelines for management of common geriatric conditions
Sponsors
ZonMw: The Netherlands Organisation for Health Research and Development
Dutch Healthcare Authority
Health insurances CZ
Health insurances UVIT
City of Nijmegen
Radboud University Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Frail community dwelling elderly patients aged 70 years or above. Frailty is determined with a two-phase screening instrument.
Exclusion criteria
* Non-frail elders * Patients in palliative or end-of-life stages of disease * Patients residing in long-term care facilities (care homes and nursing homes) * Patients already enrolled in specific dementia-related case-management programmes who lack other health-related problems * Patients not speaking or understanding the Dutch language
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall functioning | 18 months | Overall functioning is measured with the Katz-15 questionnaire. Katz-15 is embedded in the minimal data set (MDS). This MDS is used by all research projects of the Dutch National Program on Elderly Care |
| Incremental cost-effectiveness ratio (ICER) | 18 months | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Social functioning | 18 months | Social functioning is measured with the RAND-36 questionnaire. |
| Perceived health | 18 months | Perceived health is measured with the RAND-36 questionnaire abd Cantril's Self Anchoring Ladder. Both RAND-36 as Cantril's Self Anchoring Ladder are embedded in the minimal data set (MDS). |
| Perceived quality of life | 18 months | Perceived quality of life is measured with the RAND-36 questionnaire. RAND-36 is embedded in the minimal data set (MDS). This MDS is used by all research projects of the Dutch National Program on Elderly Care |
| Health care consumption | 18 months | Health care consumption including hospital resource consumption, unplanned GP care (evenings, nights and weekends), home care, temporary or permanent admission to a residential care home, temporary or permanent admission to a nursing home, day care, visits to outpatients'clinics. |
| Use of welfare services | 18 months | — |
| Utility | 18 months | Utility is measured with the EQ-5D questionnaire. EQ-5D is embedded in the minimal data set (MDS). |
| Psychological well-being | 18 months | Psychological well-being is measured with the RAND-36 questionnaire. |
Countries
Netherlands
Outcome results
None listed