Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 14;24(1):203.
doi: 10.1186/s12913-024-10635-7.

Impact of a complex health services intervention in long-term care nursing homes on 3-year overall survival: results from the CoCare study

Klaus Kaier  1 , Boris A Brühmann  2 , Stefan Fetzer  3 , Rieka von der Warth  2 , Erik Farin-Glattacker  2
Affiliations

Impact of a complex health services intervention in long-term care nursing homes on 3-year overall survival: results from the CoCare study

Klaus Kaier et al. BMC Health Serv Res. .

Abstract

Background: The Coordinated medical Care (CoCare) project aimed to improve the quality of medical care in nursing homes by optimizing collaboration between nurses and physicians. We analyze the impact of the CoCare intervention on overall survival.

Methods: The effect of time-varying treatment on 3-year overall survival was analyzed with treatment as time-varying covariate within the entire cohort. To reduce bias due to non-random assignment to treatment groups, regression adjustment was applied. Therefore, age, sex, and level of care were used as potential confounders.

Results: The study population consisted of 8,893 nursing home residents (NHRs), of which 1,330 participated in the CoCare intervention. The three-year overall survival was 49.8% in the entire cohort. NHRs receiving the intervention were associated with a higher survival probability compared to NHRs of the control group. In a univariable cox model with time-dependent treatment, the intervention was associated with a hazard ratio of 0.70 [95%CI 0.56-0.87, p = 0.002]. After adjustment for age, sex and level of care, the hazard ratio increased to 0.82 but was still significant [95%CI 0.71-0.96, p = 0.011].

Conclusion: The analysis shows that optimizing collaboration between nurses and physicians leads to better survival of NHRs in Germany. This adds to the already published favorable cost-benefit ratio of the CoCare intervention and shows that a routine implementation of optimized collaboration between nurses and physicians is highly recommended.

Keywords: Claims data; Complex intervention; Computerized documentation system; Coordinated medical care; Hospital admissions; Long-term care homes; Secondary data.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier plot of overall survival according to age
Fig. 2
Fig. 2
Simon–Makuch plots with landmark periods of 12-months (A) and 21-months (B)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Statistisches Bundesamt (Destatis). Pflegestatistik - Pflege im Rahmen der Pflegeversicherung - Ländervergleich - Pflegeheime 2019. 2020.
    1. Jacob L, Bohlken J, Kostev K. Prescription patterns and drug costs in German patients with dementia in nursing homes and home-care settings. Int J Clin Pharmacol Ther. 2017;55:9. doi: 10.5414/CP202729. - DOI - PubMed
    1. Seibert K, Stiefler S, Domhoff D, Wolf-Ostermann K, Peschke D. The influence of primary care quality on nursing home admissions in a multimorbid population with and without dementia in Germany: a retrospective cohort study using health insurance claims data. BMC Geriatr. 2022;22:1–13. - PMC - PubMed
    1. Hajek A, König H-H. Frequency and correlates of Multimorbidity among the Oldest Old: study findings from the Representative Survey on Quality of Life and Subjective Well-Being of the very old in North Rhine-Westphalia (NRW80+). Clin Interv Aging. 2023;:41–8. - PMC - PubMed
    1. Schneider J, Algharably EAE, Budnick A, Wenzel A, Dräger D, Kreutz R. High prevalence of multimorbidity and polypharmacy in elderly patients with chronic pain receiving home care are associated with multiple medication-related problems. Front Pharmacol. 2021;12:686990. doi: 10.3389/fphar.2021.686990. - DOI - PMC - PubMed