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| Name | Class |
|---|---|
| DIKOM Consortium | UNKNOWN |
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This prospective observational before-after study evaluates the impact of a Mobile Geriatric Unit (MGU) on hospitalisation rates among nursing home residents. The study includes a 12-month control phase with usual care followed by a 12-month intervention phase during which the MGU is implemented. The MGU provides advanced on-site diagnostics and telemedicine-supported specialist consultation within nursing homes.
This prospective observational before-after study evaluates the impact of a Mobile Geriatric Unit (MGU) on hospitalisation rates among nursing home residents in Saarland, Germany. The study includes a 12-month control phase with usual care followed by a 12-month intervention phase with MGU implementation in 46 nursing homes.
The MGU provides on-site advanced diagnostics (CT, X-ray, ultrasound, ECG, EEG, and laboratory testing) supported by telemedicine consultation with hospital specialists. A physician and radiology technician perform diagnostics in the nursing home, with results communicated to the general practitioner for treatment decisions within 48 hours.
Usual care involves hospital referral and in-hospital diagnostics. The intervention aims to reduce avoidable hospital admissions by providing diagnostics and specialist input directly in the nursing home.
The primary outcome is hospital admissions per person-year. Secondary outcomes include mortality, functional and cognitive status, quality of life (EQ-5D-5L), complications, healthcare costs, and 30-day hospitalisation-free survival.
Eligible participants are nursing home residents with consent or proxy consent; those requiring immediate hospitalisation are excluded.
Data are obtained from routine care and medical records, MGU documentation, structured assessments, and follow-up. Multilevel Poisson regression and interrupted time series analysis will be used.
The study was approved by the Ethics Committee of Saarland (AZ 159-21) and conducted in accordance with the Declaration of Helsinki.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Phase (Usual Care) | Usual care including general practitioner (GP) referral, hospital transport, and in-hospital diagnostics and treatment. | ||
| Intervention Phase (MGU) | On-site diagnostic evaluation using the Mobile Geriatric Unit with broad diagnostic capabilities followed by teleconsultation and further treatment by the general practitioner. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mobile Geriatric Unit (MGU) | Other | The MGU is a mobile diagnostic unit providing on-site diagnostics in nursing homes. It includes a 32-slice (64 slice reconstruction) whole body CT scanner, digital X-ray, portable ultrasound, ECG, EEG, and point-of-care laboratory diagnostics. A physician and radiology technician perform diagnostics on-site. Results are transmitted via telemedicine to hospital specialists and communicated to the general practitioner for treatment decisions within 48 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital admissions per person-year | Number of inpatient hospital admissions, excluding elective admissions. | Up to 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Mortality | Mortality | Day 180 |
| Functional status; mobility: modified Rankin Scale (mRS) | Modified Rankin Scale (mRS): 0: No symptoms
Minimum value: 0 (best outcome) Maximum value: 6 (worst outcome) |
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Inclusion Criteria:
Exclusion Criteria:
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Residents of participating nursing homes
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Klaus Fassbender, Professor | Contact | +49 681 302 75027 | klaus.fassbender@uks.eu | |
| Silke Walter | Contact | silke.walter@uni-saarland.de |
| Name | Affiliation | Role |
|---|---|---|
| Klaus Fassbender, Professor | Universität des Saarlandes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nursing Homes in Saarland | Homburg | Saarland | 66421 | Germany |
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| Day 180 |
| Functional status; frailty: Clinical Frailty Scale | Clinical Frailty Scale (as according to Moorhouse and Rockwood*):
Minimum value: 1 (best outcome) Maximum value: 9 (worst outcome) * Moorhouse P, Rockwood K. Frailty and its quantitative clinical evaluation. J R Coll Physicians Edinb 2012; 42: 333-40 | Day 180 |
| Cognitive status | The cognitive performance assessment is carried out through subjective evaluation by the nursing home's nursing staff at day 180. | Day 180 |
| Quality of life (EQ-5D-5L) | EQ-5D-5L is a standardised measure of health-related quality of life developed by the EuroQol Group and assesses health status in terms of five dimensions of health. The five levels in each dimension are worded as (1) 'not /no problems', (2) 'slight problems', (3) 'moderate problems', (4) 'severe problems' and (5) 'unable to' (mobility, self-care, usual activities), 'extreme' (pain/depression), or 'extremely' (anxiety/depression). Minimum value: 1 (best outcome) Maximum value: 5 (worst outcome) | Day 180 |
| Healthcare costs | Hospitalisation, transport, and MGU costs | Day 360 |
| 30-day hospitalisation-free survival | Hospitalisation-free survival at day 30 | Day 30 |