Background
Description of the hospital based reactivation care program
Objectives of the evaluation
Methods/Design
Evaluation design
Setting
Pilot study
Participants
Population
Inclusion criteria
-
patients aged 65 years or older
-
admitted in one of the participating hospitals and staying >48 hours
-
at risk for functional loss (ISAR HP ≥ 1)
-
ISAR HP ≥ 2 and/or MMSE ≤ 27 and/or NPI ≥ 3
Exclusion criteria
-
Unable to answer questions or follow instructions (e.g. due to severe cognitive problems (MMSE score <12/delirium/coma) within 48 hours of admission in the hospital
-
Not able to understand the Dutch language
-
Life expectancy <3 months.
Power calculation and effect size
Randomisation
Blinding
Data collection
Evaluation | Variables and+ instruments | Data collection methods | Data collection times | Notes: | ||
---|---|---|---|---|---|---|
T0 | T1 | T2 | ||||
General
| ||||||
Patient |
Demographics
| |||||
MDS (age, ethnicity, SES, education) | Interview patient |
X
|
X
|
X
| Partly at T1 and T2 | |
Patient hospital files |
X
| incl info hospital ICT | ||||
Informal caregiver |
Demographics
| |||||
MDS (relation to patient, SES etc) | Mailed paper questionnaire |
X
|
X
|
X
| Partly at T1 and T2 | |
Triage
| ||||||
Patient |
Risk for functional loss
| |||||
ISAR-HP | Interview patient |
X
| ||||
MMSE (cognitive functioning) | Interview patient |
X
| ||||
NPI-Q (neuro-psychiatric functioning) | Phone interview informal caregiver |
X
|
Patient outcome variables + instruments | Data collection methods | Data collection times | Notes: | ||
---|---|---|---|---|---|
T0 | T1 | T2 | |||
Quality of life
| |||||
SF-20 | Interview patient |
X
|
X
|
X
| 5 items part of MDS |
EQ-5D (6D) | Interview patient |
X
|
X
|
X
| Part of MDS |
SPF_IL | Interview patient |
X
|
X
| ||
Physical performance
| |||||
Katz -15 | Interview patient |
X
|
X
|
X
| Part of MDS |
Short Physical Performance Battery | "Do" test patient |
X
|
X
| ||
LAPAQ (physical activity) | Interview patient |
X
|
X
| ||
Cognitive/psycho/social performance
| |||||
NPI (neuro-psychiatric functioning) | Interview caregiver |
X
|
X
|
X
| |
MMSE (cognitive functioning) | Interview patient |
X
|
X
|
X
| Short MMSE (T1 + T2) |
Geriatric Depression Scale (depression) | Interview patient |
X
|
X
|
X
| |
Global Deterioration Scale (dementia) | Phone interview inf. caregiver |
X
|
X
|
X
| |
Loneliness scale Gierveld (social) | Interview patient |
X
| |||
Intramural Residence
| Medical registries |
X
| |||
(Re-)admission hospital/nursing home
| Interview patient/caregiver |
X
|
X
| ||
Mortality
| Medical registries |
X
|
X
| ||
Patient self management
| |||||
SMA-S | Interview patient |
X
|
X
|
Informal caregiver outcome variables + instruments | Data collection methods | Data collection times | Notes | ||
---|---|---|---|---|---|
T0 | T1 | T2 | |||
Quality of life
| |||||
EQ-6D | Mailed paper questionnaire |
X
|
X
|
X
| Part of MDS |
SF20 | Mailed paper questionnaire |
X
|
X
|
X
| 5 items part of MDS |
Carer QoL | Mailed paper questionnaire |
X
|
X
|
X
| Part of MDS |
Burden of care
| |||||
ARS (objective) | Mailed paper questionnaire |
X
|
X
|
X
| Part of MDS |
Questions on time spent on care tasks | Mailed paper questionnaire |
X
|
X
|
X
| |
CSI (subjective) | Mailed paper questionnaire |
X
|
X
|
X
| |
SRBS (subjective) | Mailed paper questionnaire |
X
|
X
|
X
| Part of MDS |
Outcome variables and instruments | Data collection methods | Data collection times | Notes | ||
---|---|---|---|---|---|
T0 | T1 | T2 | |||
Patient experiences with quality of care
| |||||
PACIC | Interview patient |
X
|
X
| ||
(H)CAPHS | Interview patient |
X
| |||
Caregiver experiences with quality of care
| |||||
SASC - adapted for elderly care (+ own formulation additional questions) | Mailed paper questionnaire |
X
| |||
Process of care delivery hospital
| |||||
Process indicators (own formulation) | Medical registers |
X
| + time after hospital discharge | ||
Process of care delivery professional view
| |||||
TCI (+ own formulation additional questions) | Mailed paper questionnaire | Last months inclusion period | |||
ACIC (only partly) | Mailed paper questionnaire | Last months inclusion period | |||
RCSP | Mailed paper questionnaire | Last months inclusion period |
Outcome variables | Data collection methods | Data collection times | Notes | ||
---|---|---|---|---|---|
T0 | T1 | T2 | |||
Health care volumes
| |||||
Period hospital admission: | Hospital registries | Time of hospital discharge | + during inclusion | ||
- amount of hospital days (days admitted)
| Hospital registries | Time of hospital discharge | |||
- total days/time admitted at ICU
| Hospital registries | Time of hospital discharge | |||
- amount of consults medical/paramedical
| Hospital registries | Time of hospital discharge | |||
- amount of large scans and diagnostics
| Hospital registries | Time of hospital discharge | |||
- amount of large treatments/operations
| Hospital registries | Time of hospital discharge | |||
- wrong bed days
| Hospital registries | Time of hospital discharge | |||
- amount of days admitted
| Hospital registries | Time of hospital discharge | |||
- amount of consults medical/paramedical
| Hospital registries, interviews personnel | Time of hospital discharge | + during inclusion | ||
- time/amount of multidisciplinary meetings
| Hospital registries, interviews personnel | Time of hospital discharge | + during inclusion | ||
Health care utilization patient in periods before and after hospital stay | Interview patient and mailed paper questionnaire primary caregiver |
X
|
X
|
X
| |
- homecare/nursing home/etc
| |||||
Average time per consult | Interviews professionals (sample) | During inclusion period | |||
Amount informal care | MDS + questionnaire informal caregiver |
X
|
X
|
X
| Amount in hours |
Amount (multidisciplinary) coordination | Interviews professionals | Amount in hours | |||
Health care prices
| |||||
price per hospital day | DBC information + manual cost research | Retrospective | Similar calculations for prices hospital, CPH, care hotels etc. | ||
price per day/hour admitted at ICU | DBC information + manual cost research | ||||
price of consults medical/paramedical | DBC information + manual cost research | ||||
price of large scans and diagnostics | DBC information + manual cost research | ||||
price of large treatments/operations | DBC information + manual cost research | ||||
costs of home care/other care | Integral costs per product cluster | Retrospective | |||
costs informal care by primary caregiver | Market price/missed wages & time | Retrospective | |||
travel costs (average) | Literature | Retrospective |