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Randomized Controlled Trial
. 2013 Jun 19:13:62.
doi: 10.1186/1471-2318-13-62.

Embrace, a model for integrated elderly care: study protocol of a randomized controlled trial on the effectiveness regarding patient outcomes, service use, costs, and quality of care

Sophie L W Spoorenberg  1 , Ronald J Uittenbroek, Berrie Middel, Berry P H Kremer, Sijmen A Reijneveld, Klaske Wynia
Affiliations
Randomized Controlled Trial

Embrace, a model for integrated elderly care: study protocol of a randomized controlled trial on the effectiveness regarding patient outcomes, service use, costs, and quality of care

Sophie L W Spoorenberg et al. BMC Geriatr. .

Abstract

Background: Ongoing growth in health care expenditures and changing patterns in the demand for health care challenge societies worldwide. The Chronic Care Model (CCM), combined with classification for care needs based on Kaiser Permanente (KP) Triangle, may offer a suitable framework for change. The aim of the present study is to investigate the effectiveness of Embrace, a population-based model for integrated elderly care, regarding patient outcomes, service use, costs, and quality of care.

Methods/design: The CCM and the KP Triangle were translated to the Dutch setting and adapted to the full elderly population living in the community. A randomized controlled trial with balanced allocation was designed to test the effectiveness of Embrace. Eligible elderly persons are 75 years and older and enrolled with one of the participating general practitioner practices. Based on scores on the INTERMED-Elderly Self-Assessment and Groningen Frailty Indicator, participants will be stratified into one of three strata: (A) robust; (B) frail; and (C) complex care needs. Next, participants will be randomized per stratum to Embrace or care as usual. Embrace encompasses an Elderly Care Team per general practitioner practice, an Electronic Elderly Record System, decision support instruments, and a self-management support and prevention program - combined with care and support intensity levels increasing from stratum A to stratum C. Primary outcome variables are patient outcomes, service use, costs, and quality of care. Data will be collected at baseline, twelve months after starting date, and during the intervention period.

Discussion: This study could provide evidence for the effectiveness of Embrace.

Trial registration: The Netherlands National Trial Register NTR3039.

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Figures

Figure 1
Figure 1
The Embrace Triangle, a population management model for service delivery based on the KP Triangle.
Figure 2
Figure 2
The Embrace study flowchart.
See this image and copyright information in PMC

References

    1. IOM (Institute of Medicine) Best care at lower cost: the path to continuously learning health care in America. Washington DC: The National Academies Press; 2012. - PubMed
    1. Colombo F, Llena-Nozal A, Mercier J, Tjadens F. Help wanted? Providing and paying for long-term care. Paris: OECD; 2011.
    1. Health reform: meeting the challenge of ageing and multiple morbidities. [ http://dx.doi.org/10.1787/9789264122314-en] - DOI
    1. Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. Journal of General Internal Medicine. 2007;22(Suppl 3):391–395. - PMC - PubMed
    1. Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, Meinow B, Fratiglioni L. Aging with multimorbidity: a systematic review of the literature. Ageing Research Reviews. 2011;10(4):430–439. doi: 10.1016/j.arr.2011.03.003. - DOI - PubMed

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