Geriatric Education & Research Institute, 2 Yishun Central 2, 768024, Singapore, Singapore.
Health Services & Outcomes Research Department, National Healthcare Group, Singapore, Singapore.
BMC Geriatr. 2022 Jul 15;22(1):586. doi: 10.1186/s12877-022-03254-6.
Frailty is increasing in prevalence internationally with population ageing. Frailty can be managed or even reversed through community-based interventions delivered by a multi-disciplinary team of professionals, but to varying degrees of success. However, many of these care models' implementation insights are contextual and may not be applicable in different cultural contexts. The Geriatric Service Hub (GSH) is a novel frailty care model in Singapore that focuses on identifying and managing frailty in the community. It includes key components of frailty care such as comprehensive geriatric assessments, care coordination and the assembly of a multi-disciplinary team. This study aims to gain insights into the factors influencing the development and implementation of the GSH. We also aim to determine the programme's effectiveness through patient-reported health-related outcomes. Finally, we will conduct a healthcare utilisation and cost analysis using a propensity score-matched comparator group.
We will adopt a mixed-methods approach that includes a qualitative evaluation among key stakeholders and participants in the programme, through in-depth interviews and focus group discussions. The main topics covered include factors that affected the development and implementation of each programme, operations and other contextual factors that influenced implementation outcomes. The quantitative evaluation monitors each programme's care process through quality indicators. It also includes a multiple-time point survey study to compare programme participants' pre- and post- outcomes on patient engagement, healthcare services experiences, health status and quality of life, caregiver burden and societal costs. A retrospective cohort study will compare healthcare and cost utilisation between participants of the programme and a propensity score-matched comparator group.
The GSH sites share a common goal to increase the accessibility of essential services to frail older adults and provide comprehensive care. This evaluation study will provide invaluable insights into both the process and outcomes of the GSH and inform the design of similar programmes targeting frail older adults.
ClinicalTrials.gov Identifier NCT04866316 . Date of Registration April 26, 2021. Retrospectively registered.
随着人口老龄化，衰弱在全球范围内的患病率不断增加。通过多学科专业团队提供的基于社区的干预措施，可以对衰弱进行管理，甚至可以逆转衰弱，但成功程度不一。然而，这些护理模式的许多实施见解具有背景性，可能不适用于不同的文化背景。新加坡的老年服务中心（GSH）是一种新的衰弱护理模式，专注于在社区中识别和管理衰弱。它包括衰弱护理的关键组成部分，如全面老年评估、护理协调和多学科团队的组建。本研究旨在深入了解影响 GSH 发展和实施的因素。我们还旨在通过患者报告的健康相关结果来确定该计划的有效性。最后，我们将使用倾向评分匹配的对照组进行医疗保健利用和成本分析。
我们将采用混合方法，包括对该计划的关键利益相关者和参与者进行定性评估，通过深入访谈和焦点小组讨论。涵盖的主要主题包括影响每个计划的发展和实施的因素、运营和影响实施结果的其他背景因素。定量评估通过质量指标监测每个计划的护理过程。它还包括一项多时间点调查研究，比较计划参与者在患者参与、医疗服务体验、健康状况和生活质量、照顾者负担和社会成本方面的预后期结果。回顾性队列研究将比较该计划参与者和倾向评分匹配对照组之间的医疗保健和成本利用情况。
GSH 站点有一个共同的目标，即为体弱老年人增加获得基本服务的机会，并提供全面的护理。这项评估研究将为 GSH 的过程和结果提供宝贵的见解，并为针对体弱老年人的类似计划的设计提供信息。
ClinicalTrials.gov 标识符 NCT04866316。注册日期 2021 年 4 月 26 日。回顾性注册。
