Assessment of Medico-economic Relevance of Care of Polypathological Patients by a Reinforced Home Nursing Care Services (SSIAD) Device

Study Overview
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Brief Summary
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The main purpose is to study, in comparison to classic Home Nursing Care Services (SSIAD), the effect of reinforced Home Nursing Care Services (SSIAD) on the occurrence of hospitalizations

Detailed Description
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It's a non-interventional, multi-centred, controlled study. Inclusions will start with patients benefit from a so-called reinforced bed in the experimental Home Nursing Care Services (SSIAD), that is, with a score between 11 and 21 on the regional public health authorities (ARS) score. Patients from the classic Home Nursing Care Services SSIAD (control arm) will be inclused on a matching mode to the individual clinical profiles of patients recruited into the reinforced Home Nursing Care Services (SSIAD). Matching will be based on age, sex, and comorbidity score (Charlson scale). Screening for matching will be done by a geriatric physician appointed by the sponsor. Once screened in, patients will be proposed the study by the Home Nursing Care Services SSIAD lead investigator who provides home care. Patients in the control arm will also express no opposition. For each patient accepting the study, their family caregiver - if there is one - will also be proposed the study. Various data: Prescription medicinal, reason and duration of hospitalization, number and reason for emergency department presentations, independence and dependency scores and other scales will be collected retrospectively, at inlcusion (J0) , then monthly (M1 to M12).

Official Title
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Assessment of Medico-economic Relevance of Care of Polypathological Patients by a Reinforced Home Nursing Care Services (SSIAD)Device

Conditions
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Polypathological Patient Having Obtained a Place in Home Nursing Care Services SSIAD by Medical Prescription

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 60 years old Having obtained a place in SSIAD by medical prescription Able to understand and respond to study questionnaires and evaluations with or without the Assistance of a third party Resident in territories of activities of the SSIAD participating in assessment With social coverage Having expressed non-oppostion to his participation in study and documented in his medical file Only for patients in  einforced SSIAD : patient with a so-called reinforced bed financed by  Regional Public Health authorities  (ARS) of Ile-de-France, and with a score between 11 and 21 on the ARS score Exclusion Criteria: Age < 60 years old Expressing his opposition to participate in the study Not resident in the territory of activity of SSIAD Requires only technical care and management in the act Unable to understand and respond to study questionnaires and evaluations, even with third party assistance

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Reinforced SSIAD (SSIADR arm )<br>Reinforced Home Nursing Care Services: Patients with a score between 11 and 21 on the regional public health authorities (ARS) score. This arm will benefit from better coordination and delivery of care, which can reduce hospitalizations and visits to emergency departments | |
| Classic SSIAD (Control arm)<br>Classic Home Nursing Care Services. For this arm, no direct benefit is expected since taking care, even for the heaviest patients, corresponds to current practice. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of hospitalization frequency for patients with Reinforced SSIAD compared to similar patients in classic SSIAD. | Assess the hospitalization frequency for patients with an enhanced SSIAD placement compared to similar patients in conventional SSIAD. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of commorbidity risk according Charlson score |  | 12 months | 
| Assessment of the degree of patient dependence according Index of Independence in Activities of Daily Living KATZ scale |  | 12 months | 
| Assessment of patient's level of dependence through an appreciation of instrumental activities of daily living according Lawton scale |  | 12 months | 
| Assessment of teh degree of autonomy according AGGIR score |  | 12 months | 
| Assessment of quality of life according Nottingham health profile scale |  | 12 months | 
| Assessment of health-related quality of life according SF-36 (Medical outcome study Short-Form health survey-36 items) |  | 12 months | 
| Assessment of the emotional, physical and financial burden on a caregiver according Zarit burden scale |  | 12 months | 
| Assessment of qualityof life for caregiver according 36-Item Short Form Survey (SF-36) Score |  | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Regional Public Health authorities (ARS) score, Reinforced Home Nursing Care Services (SSIADR)