Impact of a Health Intervention on Some Indicators in the Care of Chronic Complex Patient (CCP). (CCP)
7. april 2017 opdateret af: María José del Olmo Rubio
Impact of a Proactive and Integrated Health Intervention Between Different Assistance Levels Over Some Indicators in the Care of Chronic Complex Patient (CCP)
The aim of this study is to assess the effectiveness of proactive and integrated healthcare program for chronic complex patients (CCP).
This program are based in coordination the primary level of attention with and speciality level.
The objective is reducing hospital readmissions and know the benefit in total cost of care in 4 month before and 4 after intervention.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Quasi-experimental study with single-arm (pre-post study design without control group). The investigators checking pre and post intervention the effectiveness of a healthcare program for CCP. The interventions consist:
- - Help the nurse in the hospital to carry out the care plans and the continuity care report.
- - Refer patients to the social workers.
- - Collaborate with the social worker to refer to centers of media, long stay and reference hospital.
- - Ensure the follow-up appointments for the CCP.
- - Make proactive calls to the CCP and/or their caregiver after discharge
- - Plan the hospital discharge 48 hours in advance, so that the family and the patient can be organized.
The investigator analysed if with this program, the CCP reducing hospital readmission and reducing the Hospital expenditure.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
28
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
-
Madrid, Spanien, 28041
- Hospital Universitario 12 de Octubre de Madrid
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
75 år og ældre (Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Patient ≥ 75 years.
- Having attended 5 or more emergency visits or having had more than 3 hospital admissions in the last 12 months.
- Identified with social risk alert.
Exclusion Criteria:
- Participate in other health programs (AHT, diabetes mellitus,...).
- Terminal patient.
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Andet: Proactive healthcare intervention
Participants who were included before (single-arm pre-post study), now a proactive and integrated intervention program for the health is performed of the complex chronic patient, based in an improvement of the care process.
|
There is an intervention in the coordination of health resources, and monitoring readmissions and know the benefit in total cost of care in 4 month.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Pre-post change in days of Hospital stay from baseline to 16 weeks.
Tidsramme: Baseline and 16 weeks.
|
The same group of patients are analyzed the days of hospital stay at the end of 16 weeks of follow-up pre intervention (baseline) and 16 week after the intervention.
|
Baseline and 16 weeks.
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of hospital readmissions visits for CCP change from baseline to 16 weeks.
Tidsramme: Baseline and 16 weeks.
|
The same group of patients are analyzed the number of hospital readmissions visit for CCP at the end of 16 weeks pre intervention (considered baseline) of follow-up and 16 weeks after the intervention.
|
Baseline and 16 weeks.
|
|
Number of urgency visits for CCP change from baseline to 16 weeks.
Tidsramme: Baseline and 16 weeks.
|
The same group of patients are analyzed the number of urgency visits and primary care visit for CCP at the end of 16 weeks pre intervention (considered baseline) of follow-up and 16 weeks after the intervention.
|
Baseline and 16 weeks.
|
|
Number of primary care visits for CCP change from baseline to 16 weeks.
Tidsramme: Baseline and 16 weeks.
|
The same group of patients are analyzed the number of primary care visits for CCP at the end of 16 weeks pre intervention (considered baseline) of follow-up and 16 weeks after the intervention.
|
Baseline and 16 weeks.
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: María José del Olmo Rubio, Hospital 12 de Octubre de Madrid
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. juli 2015
Primær færdiggørelse (Faktiske)
1. juli 2016
Studieafslutning (Faktiske)
1. januar 2017
Datoer for studieregistrering
Først indsendt
16. marts 2017
Først indsendt, der opfyldte QC-kriterier
21. marts 2017
Først opslået (Faktiske)
27. marts 2017
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
10. april 2017
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
7. april 2017
Sidst verificeret
1. april 2017
Mere information
Begreber relateret til denne undersøgelse
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
INGEN
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Ingen
Studerer et amerikansk FDA-reguleret enhedsprodukt
Ingen
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .