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Caring for elderly with multimorbidity: Evaluation of ambulatory geriatric unit (AGU) (the AGe-FIT-study) : A randomized controlled trial

Ekdahl, A.W. LU ; Wirehn, Ann-Britt; Jaarsma, Tiny; Unosson, M; Alwin, Jenny; Husberg, Magnus; Wiklund, Rune; Hellström, Ingrid; Milberg, Anna and Krevers, Barbro, et al. (2014) In European Geriatric Medicine 5(Suppl. 1). p.63-64
Abstract
Importance: The care of older persons with multimorbidity is a future challenge for the welfare sector in many countries in terms of organization of care and provision of sufficient health care resources. Objective: To determine whether an alternative with an ambulatory geriatric unit (AGU) additional to usual care based on Comprehensive Geriatric Assessment (CGA) is more effective than usual care (UC) only. Design: Randomized, controlled, assessor blinded, single center trial of community dwelling patients ≥75 years, hospitalized at least three times during the past 12 months, having at least three concomitant diagnoses [intervention (AGU) n = 208, control group (UC) n = 175]. Outcomes: Hospitalizations, mortality, health related quality... (More)
Importance: The care of older persons with multimorbidity is a future challenge for the welfare sector in many countries in terms of organization of care and provision of sufficient health care resources. Objective: To determine whether an alternative with an ambulatory geriatric unit (AGU) additional to usual care based on Comprehensive Geriatric Assessment (CGA) is more effective than usual care (UC) only. Design: Randomized, controlled, assessor blinded, single center trial of community dwelling patients ≥75 years, hospitalized at least three times during the past 12 months, having at least three concomitant diagnoses [intervention (AGU) n = 208, control group (UC) n = 175]. Outcomes: Hospitalizations, mortality, health related quality of life (HRQoL) and costs of care. Results: After 24 months there was no difference in number of hospitalizations (2.1 in AGU versus 2.4 in CG (P = 0.19). However, patients in AGU had less inpatient days (11.1) compared to the UC (15.2) (P = 0.03). Further, the UC had 54% higher mortality rate than the IG (HR = 1.54 (95% CI: 1.01-2.34), P = 0.046). The cost of care was € 19,941 in the AGU and € 17,730 in the UC group. There was no difference in HRQoL between the groups. Conclusion: The superiority of the alternative with AGU in important findings such as decreased inpatient days and mortality, but to slightly higher total cost after 24 months follow up. This finding is important knowledge when organizing the care for the elderly. (Less)
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type
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publication status
published
keywords
immunoglobulin, human, geriatrics, randomized controlled trial, European Union, society, aged, mortality, hospitalization, patient, hospital patient, welfare, control group, follow up, diagnosis, community, quality of life, geriatric assessment, health care
in
European Geriatric Medicine
volume
5
issue
Suppl. 1
pages
2 pages
publisher
Elsevier Masson SAS
ISSN
1878-7649
DOI
10.1016/S1878-7649(14)70131-7
language
English
LU publication?
no
id
86ca7f3a-07a4-4b3e-abd6-6be1a23a2047
date added to LUP
2017-05-21 10:34:26
date last changed
2017-11-14 09:49:42
@misc{86ca7f3a-07a4-4b3e-abd6-6be1a23a2047,
  abstract     = {Importance: The care of older persons with multimorbidity is a future challenge for the welfare sector in many countries in terms of organization of care and provision of sufficient health care resources. Objective: To determine whether an alternative with an ambulatory geriatric unit (AGU) additional to usual care based on Comprehensive Geriatric Assessment (CGA) is more effective than usual care (UC) only. Design: Randomized, controlled, assessor blinded, single center trial of community dwelling patients ≥75 years, hospitalized at least three times during the past 12 months, having at least three concomitant diagnoses [intervention (AGU) n = 208, control group (UC) n = 175]. Outcomes: Hospitalizations, mortality, health related quality of life (HRQoL) and costs of care. Results: After 24 months there was no difference in number of hospitalizations (2.1 in AGU versus 2.4 in CG (P = 0.19). However, patients in AGU had less inpatient days (11.1) compared to the UC (15.2) (P = 0.03). Further, the UC had 54% higher mortality rate than the IG (HR = 1.54 (95% CI: 1.01-2.34), P = 0.046). The cost of care was € 19,941 in the AGU and € 17,730 in the UC group. There was no difference in HRQoL between the groups. Conclusion: The superiority of the alternative with AGU in important findings such as decreased inpatient days and mortality, but to slightly higher total cost after 24 months follow up. This finding is important knowledge when organizing the care for the elderly.},
  author       = {Ekdahl, A.W. and Wirehn, Ann-Britt and Jaarsma, Tiny and Unosson, M and Alwin, Jenny and Husberg, Magnus and Wiklund, Rune and Hellström, Ingrid and Milberg, Anna and Krevers, Barbro and Carlsson, P.},
  issn         = {1878-7649},
  keyword      = {immunoglobulin,human,geriatrics,randomized controlled trial,European Union,society,aged,mortality,hospitalization,patient,hospital patient,welfare,control group,follow up,diagnosis,community,quality of life,geriatric assessment,health care},
  language     = {eng},
  month        = {09},
  note         = {Conference Abstract},
  number       = {Suppl. 1},
  pages        = {63--64},
  publisher    = {Elsevier Masson SAS},
  series       = {European Geriatric Medicine},
  title        = {Caring for elderly with multimorbidity: Evaluation of ambulatory geriatric unit (AGU) (the AGe-FIT-study) : A randomized controlled trial},
  url          = {http://dx.doi.org/10.1016/S1878-7649(14)70131-7},
  volume       = {5},
  year         = {2014},
}