NCT03111004

BeyondSilos - More Personalised and Coordinated Care and Improved Outcomes for Elderly Patients

BeyondSilos - Integrated Care Leading to a More Personalised and Coordinated Care, Improving Outcomes for Elderly Patients, Delivering More Effective Care and Support, and Provide More Cost Efficient Health and Social Services

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 1,840 (actual)
• Sponsor: Him SA · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

The study evaluates the impact of the new organisational models developed in the framework of the BeyondSilos pilot service in order to provide ICT supported integrated health and social care to elderly patients

Detailed description

The overall aim of the evaluation carried out in BeyondSilos is to identify the differences introduced by implementing ICT supported integrated care in different domains according to the MAST evaluation framework, including safety, clinical and social outcomes, resource use and cost of care, user/carer experience and organisational changes. The focus of the evaluation will be the impact of so called "horizontal" integration, which is the integration between social care and health care, and the changing organisational models for elderly patients. The hypothesis in this study is that integrated care (IC) will lead to a more personalised and coordinated care, improve outcomes for elderly patients, deliver more effective care and support, and provide more cost efficient health and social services.

Conditions

• Heart Failure
• Stroke
• COPD
• Diabetes

Interventions

Type	Name	Description
OTHER	New Care	All settings that are in any way relevant to the provision of health and social care are integrated, including: out-of-hospital (community) services as well as hospitals, GPs' offices, community nurses, and any type of care practitioners, users' homes and volunteer service providers' offices

Timeline

• Start date: 2014-09-01
• Primary completion: 2016-06-30
• Completion: 2017-10-01
• First posted: 2017-04-12
• Last updated: 2018-08-20