Mobile geriatric teams – A cost-effective way of improving patient safety and reducing traditional healthcare utilization among the frail elderly? A randomized controlled trial

Research output: Contribution to journalArticle

Abstract

Background: Demographic changes combined with costly technological progress put a financial strain on the healthcare sector in the industrialized world. Hence, there is a constant need to develop new cost-effective treatment procedures in order to optimize the use of available resources. As a response, the concept of a Mobile Geriatric Team (MGT) has emerged not only nationally but also internationally during the last decade; however, scientific evaluation of this initiative has been very scarce. Thus, the objective of this study was to perform a mixed methods analysis, including a prospective, controlled and randomized quantitative evaluation, in combination with an interview-based qualitative assessment, to measure the effectiveness and user satisfaction of MGT. 

Materials and methods: Community-dwelling, frail elderly people were randomized to an intervention group (n=31, mean age 84) and a control group (n=31, mean age 86). A twoyear retrospective quantitative data collection and a prospective one-year follow-up on healthcare utilization were combined with qualitative interviews. Non-parametric statistics and difference-in-difference (DiD) analyses were applied to the quantitative data. Qualitative data were analyzed using content analysis. 

Results: No significant group differences in healthcare utilization were found before inclusion. Post intervention, primary care contact (includingMGTs) increased for theMGT group. Inpatient care decreased dramatically for both groups. Hence, the increase in primary care contact forMGT patients was not accompanied by a reduction in inpatient care compared to the control group. Utilization of non-primary care was lower (p< 0.01) post-intervention in both groups. 

Conclusion: There appears to be a “natural” variation in healthcare needs over time among frail elderly people. Hence, it is vital to perform open, controlled clinical studies in tandem with the implementation of new caregiving strategies. The MGT initiative was clearly appreciated but did not fully achieve the desired reduction in healthcare utilization in this study. 

Details

Authors
Organisations
External organisations
  • Jönköping University
  • Karolinska Institutet
  • Futurum - Academy for Health and Care
  • Jönköping International Business School
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Health Care Service and Management, Health Policy and Services and Health Economy

Keywords

  • Frail elderly, Healthcare utilization, Mobile geriatric team, Patient safety, Quality of life
Original languageEnglish
Pages (from-to)1911-1924
Number of pages14
JournalClinical Interventions in Aging
Volume14
Publication statusPublished - 2019 Nov
Publication categoryResearch
Peer-reviewedYes