Background
Care problems of elderly in homes for the elderly
Disease Management Model
The Disease Management Model in residential homes
Chronic disorders and homes for the elderly in the Netherlands
Costs
Methods
Design
Randomization
Eligibility of residents
Procedure
Variable | Instrument | Baseline | 6 months |
---|---|---|---|
Primary outcome
| |||
a. Quality of Care | RAI-LTCF criteria | X | X |
b. Quality Adjusted Life Years | Euroqol & thermometer | X | X |
c. Functional health | COOP-WONCA & SF12 | X | X |
Secondary outcome
| |||
d. Patient care satisfaction | Brief Quote on elderly Homes | X | X |
e. Disability ADL-IADL | Groningen Activity Restriction Scale | X | X |
f. Mood disorders | PRIME-MD | X | X |
g. Hospital days | Checklist resource utilization Hospital records | X | X |
h. Time to nursing home placement | Registration elderly home HIS | X | |
i. Time to mortality | Registration elderly home HIS | X | |
Economic outcomes | |||
Direct costs | Patient/family Interview Registration pharmacy Registration medical records | X | |
Process outcomes
| |||
Adherence professionals to disease management protocol | Checklist | X | |
Adherence of patients to specific disease management recommendations | Checklist | X | |
Potential Effect Modifiers | |||
-Sociodemographics | Patient Interview | X | |
-Health status (morbidity, medication) | Patient Interview Patient records | X | X |
-House & personnel characteristics | Staff Interview | X |
Intervention(s)
Problems and risks | Observed | Action now? |
---|---|---|
Delirium | ||
Cognition impairment /dementia | ||
Visual impairment | x | |
Communication | x | |
ADL-revalidation potential | x | x |
IADL-more formal care needed | ||
Urinal incontinence | x | |
Psychosocial wellbeing | x | x |
Depression | x | |
Behavior | ||
Social activities | x | |
Falls | x | x |
Nutrition | x | |
Artificial nutrition | ||
Dehydration | ||
Dental health | ||
Skin problems and wounds | x | x |
Psychotropic medication-walking problems | ||
Psychotropic medication- cognitive and behavioral problems | ||
Psycho medicaments and feeling unwell | ||
Fixation |