Growing old at home - a randomized controlled trial to investigate the effectiveness and cost-effectiveness of preventive home visits to reduce nursing home admissions: study protocol [NCT00644826]

Fleischer, Steffen; Roling, Gudrun; Beutner, Katrin; Hanns, Stephanie; Behrens, Johann; Luck, Tobias; Kuske, Bettina; Angermeyer, Matthias C.; Riedel-Heller, Steffi G.; Heinrich, Sven; König, Hans-H.; Lautenschläger, Christine
January 2008
BMC Public Health;2008, Vol. 8 Issue 1, p185
Academic Journal
Background: Regarding demographic changes in Germany it can be assumed that the number of elderly and the resulting need for long term care is increasing in the near future. It is not only an individual's interest but also of public concern to avoid a nursing home admission. Current evidence indicates that preventive home visits can be an effective way to reduce the admission rate in this way making it possible for elderly people to stay longer at home than without home visits. As the effectiveness and cost-effectiveness of preventive home visits strongly depends on existing services in the social and health system existing international results cannot be merely transferred to Germany. Therefore it is necessary to investigate the effectiveness and cost-effectiveness of such an intervention in Germany by a randomized controlled trial. Methods: The trial is designed as a prospective multi-center randomized controlled trial in the cities of Halle and Leipzig. The trial includes an intervention and a control group. The control group receives usual care. The intervention group receives three additional home visits by non-physician health professionals (1) geriatric assessment, (2) consultation, (3) booster session. The nursing home admission rate after 18 months will be defined as the primary outcome. An absolute risk reduction from a 20% in the control-group to a 7% admission rate in the intervention group including an assumed drop out rate of 30% resulted in a required sample size of N = 320 (n = 160 vs. n = 160). Parallel to the clinical outcome measurement the intervention will be evaluated economically. The economic evaluation will be performed from a society perspective. Discussion: To the authors' knowledge for the first time a trial will investigate the effectiveness and cost-effectiveness of preventive home visits for people aged 80 and over in Germany using the design of a randomized controlled trial. Thus, the trial will contribute to the existing evidence on preventive home visits especially in Germany.


Related Articles

  • FUTURE NEEDS FOR LONG-TERM CARE. Huhn, Bob // Public Management (00333611);Oct2007, Vol. 89 Issue 9, p34 

    The article discusses the importance of an adult long-term care in the U.S. The number of people 65 years old and above are expected to double by 2040 and will depend on such services. According to a report by Term Care Needs of the Baby Boomers: How Changing Families Will Affect Paid Helpers...

  • Exploring the Relationships Between Families and Staff Caring for Residents in Long-Term Care Facilities: Family Members' Perspectives. Gladstone, James; Wexler, Evelyn // Canadian Journal on Aging;Spring2002, Vol. 21 Issue 1, p39 

    The purpose of this qualitative study was to learn more about the relationships that families develop with staff who work in the facilities in which their relatives live. Data were collected through participant observation in two long-term care facilities and through personal interviews with 61...

  • Long-Term Care for Older Adults. Maas, Meridean // Journal of Gerontological Nursing;Oct2004, Vol. 30 Issue 10, p3 

    Suggests the need for a new paradigm for the long-term care and quality of life of older adults in the U.S. in 2006. Problem with current long-term care services for older people; Reason for a few options for long-term care services that promote quality of life, health and function; Changes...

  • Aged care homes a serious risk.  // Australian Nursing Journal;May2009, Vol. 16 Issue 10, p6 

    The article discusses the imposition of sanctions on healthcare facilities in Australia. The Dija Meta Aged and Disabled Hostel in north Queensland presented risks to its residents that included choking, infection, and a call system that was ineffective. The provider license for the Norwood...

  • Documenting the need for health care screening: A status report. Wolf-Klein, Gisele // Geriatrics;Dec1989, Vol. 44 Issue 12, p41 

    The article reports on the need for health care screening. The controversy over whether routine physical evaluations of healthy elderly are worthwhile is not a new one. In a study at the Parker Jewish Geriatric Institute, New Hyde Park, New York, emphasized on the yearly screening of...

  • Caregivers of Frail Elders: Updating a National Profile. Wolff, Jennifer L.; Kasper, Judith D. // Gerontologist;Jun2006, Vol. 46 Issue 3, p344 

    Purpose: Family caregivers comprise the backbone of long-term-care provision in the United States, yet little is known about how the composition and experience of Family caregiving has changed over time. Design and Methods: Data are drawn from the 1989 and 1999 National Long-Term Care Survey and...

  • Recent Trends in Advance Directives at Nursing Home Admission and One Year After Admission. McAuley, William J.; Buchanan, Robert J.; Travis, Sniriey S.; Suojin Wang; Myungsuk Kim // Gerontologist;Jun2006, Vol. 46 Issue 3, p377 

    Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence...

  • Governance and Management Structures for Community Partnerships: Experiences From the Robert Wood Johnson Foundation's Community Partnerships for Older Adults Program. Bolda, Elise J.; Saucier, Paul; Maddox, George L.; Wetle, Terrie; Lowe, Jane Isaacs // Gerontologist;Jun2006, Vol. 46 Issue 3, p391 

    Purpose: This article describes early efforts of four community partnerships in Boston, El Paso, Houston, and Milwaukee to address governance and management structures in ways that promote the sustainability of innovative community-based long-term care system improvements. The four communities...

  • Transitional care facility for elderly people in hospital awaiting a long term care bed: randomised controlled trial. Crotty, Maria; Whitehead, Craig H.; Wundke, Rachel; Giles, Lynne C.; Ben-Tovim, David; Phillips, Paddy A. // BMJ: British Medical Journal (International Edition);11/12/2005, Vol. 331 Issue 7525, p1110 

    Objective To assess the effectiveness of moving patients who are waiting in hospital for a long term care bed to an off-site transitional care facility. Design Randomised controlled trial. Setting Three public hospitals in Southern Adelaide. Participants 320 elderly patients (mean age 83 years)...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics