Potential of Interface Care Models to Deliver More Appropriate Care to Patients With Acute Medical Illness

April 10, 2026 updated by: National University Hospital, Singapore

Potential of Interface Care Models to Deliver More Appropriate Care to Patients With Acute Medical Illness in Singapore and Decrease Utilisation of Acute Care Bed-days

Every country in the world is experiencing growth in both the size and the proportion of older persons. As a result of the changes, the profile and needs of people with medical illnesses have evolved. How care is delivered to patients has to keep pace with these changes, or patients will experience poor care at high cost and not have their needs met. A new model of care has emerged to meet these challenges: Acute Medical Unit. Despite considerable investment and popularity of this model, questions remain: (i) Who benefits most from this care model? (ii) How may these models be most effectively implemented for the best results? (iii) How effective are these models? Singapore is well-placed to answer these questions with its national healthcare system and excellent research institutions. The investigators plan to study how effective the model is by comparing patients with similar profiles exposed to both these care models compared to how hospital care is usually provided, looking for four differences: (i) how long patients stay in hospital, (ii) how often they use the emergency department (iii) quality of health (iv) cost. Additionally, the investigators seek to characterise patterns of health needs for this group of patients.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
220

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Singapore
      • Singapore, Singapore, 119228
        • Recruiting
        • National University Hospital
        • Contact:
        • Principal Investigator:
          • John TY Soong, PhD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population will consist of adult patients admitted to the National University Hospital (NUH), Singapore, for acute medical conditions. Participants will be recruited either from the Acute Medical Unit (AMU) or directly to the General Ward (GW) following presentation to the Emergency Department. Patients represent a typical mix of acute medical admissions seen in a tertiary hospital setting, including infection-related illnesses, falls with disequilibrium, and acute exacerbations of chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD).

Description

Inclusion Criteria:

  • AMU inclusion criteria - admission from ED to AMU directly
  • Control group inclusion criteria - admission from ED to GW directly
  • Acute medical illnesses that includes infection-related conditions, falls-disequilibrium, and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).

Exclusion Criteria:

  • Below 21 years old
  • Patients undergoing active chemotherapy
  • Patients with active pregnancy
  • Patients admitted less than 24 hours
  • Cerebrovascular disease requiring thrombolysis or intravascular intervention

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Acute Medical Unit (AMU) Patients
Patients admitted to the AMU from the Emergency Department (ED) or specialist clinics as their first admission ward. The AMU provides rapid assessment and early intervention to improve efficiency of care. Participants will primarily include adults with acute medical illnesses such as infection-related conditions, falls/disequilibrium, or acute exacerbation of COPD.
General Ward (GW) Control Patients
Patients admitted directly from the ED to General Wards under the Division of Advanced Internal Medicine. Patients will be matched to the AMU group by diagnosis group, age, gender, illness severity, comorbidities, frailty, and functional status to minimize confounding factors.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Mean acute care bed-days utilised
Time Frame: Up to 6 months following discharge
Average total days of acute hospital stay, including the index episode, for each patient. Measures efficiency of hospital care between AMU and GW groups.
Up to 6 months following discharge

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Patient Outcomes - Health-related Quality of Life (EQ-5D-5L)
Time Frame: Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patients rate 5 areas - mobility, self-care, usual activities, pain/discomfort, and anxiety/depression on a 5-level scale from 1 (no problems) to 5 (extreme problems). Scores are combined into an overall health index, where higher scores indicate worse health status. This captures the patient's overall quality of life over the follow-up period.
Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient Outcomes - Patient Activation Measure (PAM-13)
Time Frame: Baseline (Day 0, at discharge) and 6 months post-discharge
Patients answer 13 questions on a 4-point scale from "strongly disagree" to "strongly agree," with a "not applicable" option. Raw scores are converted to a 0-100 scale, where higher scores indicate greater engagement in self-care. Scores classify patients into four levels: Level 1 = disengaged, Level 2 = gaining confidence, Level 3 = taking action, Level 4 = confident and maintaining self-management.
Baseline (Day 0, at discharge) and 6 months post-discharge
Patient Outcomes - World Health Organisation Five Wellbeing (WHO-5)
Time Frame: Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient answers five questions that assess mood, energy, and interest in daily life over the past two weeks, scored 0 (at no time) to 5 (all of the time). The total score (0-25) is multiplied by 4 to create a 0-100 scale, where higher scores indicate better wellbeing.
Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient Outcomes - Patient Health Questionnaire (PHQ-9)
Time Frame: Baseline (Day 0, at discharge) and 6 months post-discharge
PHQ-9 includes 9 items scored 0 (not at all) to 3 (nearly every day), total 0-27; higher scores indicate more severe depressive symptoms.
Baseline (Day 0, at discharge) and 6 months post-discharge
Patient Outcomes - Functional Dependence (Barthel Index)
Time Frame: Baseline (Day 0, at discharge) and 6 months post-discharge
Measures independence in 10 daily activities, scored 0 (fully dependent) to 100 (fully independent). Higher scores indicate greater ability to perform daily activities without assistance.
Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Number of Emergency Department (ED) visits
Time Frame: Baseline (Day 0, at discharge) and 6 months post-discharge
Number of ED visits recorded in hospital records within 6 months. Higher counts reflect greater acute care needs.
Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Specialist Outpatient Clinic visit
Time Frame: Baseline (Day 0, at discharge) and 6 months post-discharge
Number of outpatient specialist visits, as recorded in hospital system.
Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Polyclinic Visits
Time Frame: Baseline (Day 0, at discharge) and 6 months post-discharge
Number of visits to public polyclinics captured through health records
Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Hospital Admissions
Time Frame: 6 months post-discharge
Number of inpatient hospital admissions during follow-up, excluding the index admission.
6 months post-discharge

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Cost-effectiveness
Time Frame: Up to 6 months from discharge
Estimate the change to 'total costs' and the change to 'health benefits' as measured by Quality Adjusted Life Years (QALYS) from a decision to adopt AMU as compared to the 'existing acute care chain' in Singapore
Up to 6 months from discharge

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
National University Hospital, Singapore

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Duke-NUS Graduate Medical School

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 30, 2024

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 31, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 31, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 25, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 10, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 17, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 17, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 10, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • MOH-001435-00

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

At the time of study planning, no identified repository existed for this data. Researchers are welcome to contact the Principal Investigator directly.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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