Costs and Cost Analysis, Delivery of Health Care, Health Services, Quality of Life
Conditions
Keywords
patient-centred care, patient-centred medical home, older adults, complex needs, healthcare utilisation, economic evaluation, cost analysis, health services research
Brief summary
This study evaluates the Community for Successful Ageing (ComSA) Patient-Centered Medical Home (PCMH), a model of community-based primary care geriatric hub at Whampoa, Singapore.
Detailed description
This study evaluates the Community for Successful Ageing (ComSA) Patient-Centered Medical Home (PCMH), a model of community-based primary care geriatric hub at Whampoa, Singapore. This study aims to evaluate the impact of ComSA PCMH on health service utilisation, healthcare cost, clinical quality and effectiveness, as well as patient activation, quality of life, satisfaction and experience of care. The first component of the study is a single arm prospective pre-post cohort design, which aims to evaluate the impact on enrolled patients' self-reported health outcomes, experience of care, and cost effectiveness. The second component of the study evaluates the quality of the implementation processes via clinical quality indicators. The third component is a match-controlled retrospective pre-post study design, which aims to evaluate the impact on healthcare utilisation. Data sources include both survey data and administrative data.
Interventions
OTHERPatient-centred care home (PCMH)
New model of care defined by care provision by a team of people centered in the community that is both proactive and coordinated to improve the health and wellness of the people in that community.
Sponsors
Tsao Foundation
National Healthcare Group, Singapore
Geriatric Education and Research Institute
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
Key inclusion criteria: i. Aged 40 years and above ii. Lives in Whampoa, Singapore iii. Enrolled in PCMH after 1 September 2017
Exclusion criteria
i. Aged less than 40 years ii. Does not live in Whampoa Singapore
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Healthcare utilisation: Primary care | Change from baseline to post-3 months, and to post-6 months | Primary care visits |
| Healthcare utilisation: Inpatient visits | Change from baseline to post-3 months, and to post-6 months | Inpatient visits |
| Healthcare utilisation: Specialist outpatient care | Change from baseline to post-3 months, and to post-6 months | Specialist outpatient clinic visits |
| Healthcare utilisation: A&E | Change from baseline to post-3 months, and to post-6 months | A&E visits |
| Patient-reported outcome measure for patient activation | Change from baseline to post-3 months, and to post-6 months | PAM-13 |
| Patient-reported outcome measure for quality of life | Change from baseline to post-3 months, and to post-6 months | EQ-5D-5L |
| Patient-reported outcome measure for quality of life in old age | Change from baseline to post-3 months, and to post-6 months | CASP-19 |
| Patient experience of care | 6 months | CAHPS |
| Economic evaluation and cost analysis | Change from baseline to post-3 months, and to post-6 months | Cost comparison between intervention group and non-intervention group |
Countries
Singapore
Outcome results
None listed