Chronic Illness Clinical Trial
Official title:
Enabling Elderly Patients to Manage Their Own Lives - A Systematic Management Program for Home Care Services.
The ambition of this study is to raise the quality of care for old and chronically ill
patients by establishing a sustainable, systematic prevention and integrated care model for
users of home care services.
In this cluster randomized study the intervention will be carried through in five
municipalities and three general hospitals. The home care units in every municipality will
be randomized to either intervention og control units.
The primary objective of this study is to develop a functional and integrated care model
between primary and secondary health care that will meet the needs both in the city and in
smaller rural areas.
The secondary objective of this study is to reduce the need of care at primary and secondary
level through a a systematic and integrated follow-up by home care nurses and general
practitioners to:
- Enable these patients to manage their health needs more efficiently and independently
- Achieve better collaboration within primary care
- Achieve better collaboration between primary- and secondary health care professionals
- Achieve increased satisfaction and confidence with the health care services by the
users and their relatives both for included patients and other patients receiving home
care services.
- Promote health and prevent unnecessary decline in health
- Strengthen the patients' ability to manage their daily activities.
;
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