Transition Clinical Trial
Official title:
The Effects of a Health-social Partnership Program for Discharged Non-frail Older Adults: a Pilot Study
Previous studies supporting discharged patients are hospital-based which admission criteria tend to include mainly those with complex needs and/or specific disease conditions. This study captured the service gap where these non-frail older patients might have no specific medical problem upon discharge but they might encounter residual health and social issues when returning home.
Objective: To compare the effect of a community-based health-social partnership program with
usual care for discharged community-dwelling non-frail older adults on their healthârelated
quality of life, activities of daily living, depressive symptoms, and use of health services.
Design: A randomized controlled trial. Participants: Discharged community-dwelling non-frail
older adults from an emergency medical ward in an intervention (n=37) and a control (n=38)
group.
Interventions: Discharged older adults were randomized to receive usual care or complex
interventions, including structured assessment, health education, goal empowerment, and care
coordination supported by a health-social team.
Main measures: The outcomes were measured at pre-intervention (T1) and at three months
post-intervention (T2) using the Medical Outcomes Study 12-item Short Form, the Modified
Barthel Index and the Geriatric Depression Scale.
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