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Long-term evaluation of the ambulatory geriatric assessment-a frailty intervention trial (AGE-FIT)-clinical outcomes and total costs after 36 months

Ekdahl, A.W. LU ; Wirehn, Ann-Britt and Alwin, Jenny (2015) In European Geriatric Medicine 6(Suppl 1). p.179-179
Abstract
Objective: To compare mortality and costs of health and social care between participants with access to care based on Comprehensive Geriatric Assessment (CGA) in an out-patient care setting with a control group receiving usual care only. The comparison was done 36 months after inclusion. Methods: Randomized controlled trial. Inclusion criteria: community-dwelling, aged ≥75 years, ≥3 hospitalisations the last year and ≥3 medical diagnoses. Mean age 82.5 years. Results: A total of 208 participants in the intervention group (IG) and 174 in the control group (CG). Participants in the IG lived longer than the participants in the CG. 27.9% (n = 58) in the IG versus 38.5% (n = 67) in the CG had died. HR= 1.49; CI; 1.05-2.12; P = 0.026. Mean... (More)
Objective: To compare mortality and costs of health and social care between participants with access to care based on Comprehensive Geriatric Assessment (CGA) in an out-patient care setting with a control group receiving usual care only. The comparison was done 36 months after inclusion. Methods: Randomized controlled trial. Inclusion criteria: community-dwelling, aged ≥75 years, ≥3 hospitalisations the last year and ≥3 medical diagnoses. Mean age 82.5 years. Results: A total of 208 participants in the intervention group (IG) and 174 in the control group (CG). Participants in the IG lived longer than the participants in the CG. 27.9% (n = 58) in the IG versus 38.5% (n = 67) in the CG had died. HR= 1.49; CI; 1.05-2.12; P = 0.026. Mean number of inpatient days was lower in the IG (intervention 15.1 (SD 18.4), control 21.0 (SD 25.0), P = 0.01. No differences in the overall costs between the IG and CG including costs for home-help service and nursing home. Mean cost during the 36-month period after baseline assessment expressed as USD/patient (SD) in the IG was 71905 (85560) versus 65626 (66338) in the CG: P = 0.43. Conclusion: Better survival and fewer days in hospital three years after baseline assessment without increasing costs. This strengthens the positive results of a care based on CGA not only in acute care settings but also in outpatient care. A change of to-days health care organization focused on a one organ/disease is needed to a more comprehensive and preventive care of the oldest old. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
keywords
immunoglobulin, intervention study, European Union, geriatrics, society, geriatric assessment, human, control group, randomized controlled trial, social care, mortality, survival, emergency care, patient care, health, diagnosis, hospital patient, home care, nursing home, community, hospital, outpatient, outpatient care, health care organization
in
European Geriatric Medicine
volume
6
issue
Suppl 1
pages
1 pages
publisher
Elsevier Masson SAS
ISSN
1878-7649
language
English
LU publication?
no
id
6423019f-02de-4789-8067-1e9e91bf35da
date added to LUP
2017-05-21 10:33:35
date last changed
2017-08-23 13:25:15
@misc{6423019f-02de-4789-8067-1e9e91bf35da,
  abstract     = {Objective: To compare mortality and costs of health and social care between participants with access to care based on Comprehensive Geriatric Assessment (CGA) in an out-patient care setting with a control group receiving usual care only. The comparison was done 36 months after inclusion. Methods: Randomized controlled trial. Inclusion criteria: community-dwelling, aged ≥75 years, ≥3 hospitalisations the last year and ≥3 medical diagnoses. Mean age 82.5 years. Results: A total of 208 participants in the intervention group (IG) and 174 in the control group (CG). Participants in the IG lived longer than the participants in the CG. 27.9% (n = 58) in the IG versus 38.5% (n = 67) in the CG had died. HR= 1.49; CI; 1.05-2.12; P = 0.026. Mean number of inpatient days was lower in the IG (intervention 15.1 (SD 18.4), control 21.0 (SD 25.0), P = 0.01. No differences in the overall costs between the IG and CG including costs for home-help service and nursing home. Mean cost during the 36-month period after baseline assessment expressed as USD/patient (SD) in the IG was 71905 (85560) versus 65626 (66338) in the CG: P = 0.43. Conclusion: Better survival and fewer days in hospital three years after baseline assessment without increasing costs. This strengthens the positive results of a care based on CGA not only in acute care settings but also in outpatient care. A change of to-days health care organization focused on a one organ/disease is needed to a more comprehensive and preventive care of the oldest old.},
  author       = {Ekdahl, A.W. and Wirehn, Ann-Britt and Alwin, Jenny},
  issn         = {1878-7649},
  keyword      = {immunoglobulin,intervention study,European Union,geriatrics,society,geriatric assessment,human,control group,randomized controlled trial,social care,mortality,survival,emergency care,patient care,health,diagnosis,hospital patient,home care,nursing home,community,hospital,outpatient,outpatient care,health care organization},
  language     = {eng},
  month        = {09},
  note         = {Conference Abstract},
  number       = {Suppl 1},
  pages        = {179--179},
  publisher    = {Elsevier Masson SAS},
  series       = {European Geriatric Medicine},
  title        = {Long-term evaluation of the ambulatory geriatric assessment-a frailty intervention trial (AGE-FIT)-clinical outcomes and total costs after 36 months},
  volume       = {6},
  year         = {2015},
}