Evaluation of the Singapura Program of All Inclusive Care for the Elderly
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 80
- 试验地点
- 2
- 主要终点
- Number of EMT and acute care events
研究概览
简要总结
This is a RCT studying the effectiveness of the Singapore Program for All Inclusive Care for the Elderly (SingaPACE) demonstration project over a 36 month period. SingaPACE is modelled on the US PACE home and community based service that acts as an alternative to institutional care. The comparator is best referrals for care as currently arranged through the Agency for Integrated Care (AIC) and referred by medical social workers. This research aims to determine how the SingaPACE model of health and social care affects use of emergency and acute care hospital services, institutional care, the quality of life (QOL) and satisfaction of the participants aged 60+ and their caregivers.
The hypotheses to be tested are:
H01: The elderly in SingaPACE will have fewer admissions to accident & emergency (A&E) hospitalization than the elderly who are not in SingaPACE.
H02: The elderly in SingaPACE will have fewer admissions to acute care hospitalization than the elderly who are not in SingaPACE.
H03: The elderly in SingaPACE will delay first admission to institutionalized nursing home care more than the elderly who are not in SingaPACE.
H04: The elderly in SingaPACE clients will have a higher QOL compared to the elderly who are not in SingaPACE.
H05: Caregivers of the elderly in SingaPACE will have a lower care-giving burden compared to caregivers of the elderly who are not in SingaPACE.
详细描述
* Recruitment
Potential subjects will be identified from i) inpatients referred prior to discharge and ii) outpatients to medical social workers from Singapore General Hospital (SGH) and Alexandra Hospital (AH). After confirming study eligibility the medical social worker will inform the potential subject about the study; after obtaining informed consent, the medical social worker will make a telephone call to the Duke - NUS research fellow who will then carry out the randomization process, assigning the subject to either the intervention group or the control group.
* Sites
The SingaPACE program will be located at 298, Tiong Bahru Road, #15-01/06 Central Plaza and at NTUC Eldercare, Block 117, Bukit Merah View.
* Procedures
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Individuals aged 60 and above;
- •The frail elderly classified as high Category2 - Category 3 under the Residence Assessment Form(RAF);
- •Are willing to enroll in SingaPACE if they were selected in a fair lottery draw or to be followed up similarly over 36 months if not selected;
- •Residing within the Bukit Merah catchment area;
排除标准
- •Bed Bound;
- •Are undergoing dialysis treatment,
- •Radiotherapy or chemotherapy; or
- •Have behavioral and psychological symptoms of dementia(BPSD)prior to enrollment in the research study.
研究组 & 干预措施
Control Group
Individuals randomized into the control arm will receive usual community care services referred by the social worker from SGH and AH.
Intervention Group
Individuals in the intervention group will go through an integrated program of community based health and social care based on intake and ongoing evaluation by the SingaPACE team.
干预措施: SingaPACE (Behavioral)
结局指标
主要结局
Number of EMT and acute care events
时间窗: 36 months
The primary outcome measure will be the number of EMT events, A\&E visits or acute care hospitalizations captured based on the following possible sequence of events: * The number of EMT events or * The number of EMT events leading to A\&E events or * The number of EMT events leading to A\&E events that lead to acute care hospitalizations or * The number of A\&E events or * The number of A\&E events that lead to acute care hospitalizations or * The number of acute care hospitalizations
次要结局
- Patient Quality of Life(36 months)
- Admission to institutionalized nursing home(36 months)
- Length of stay in acute care(36 months)
- Caregiver burden(36 months)
研究者
Dr. David Matchar
Professor
National University of Singapore