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. 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.

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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

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