The COPACC Study: Utilization, Health and Economic Evaluation of a Community-Based Primary Care Geriatric Hub at Whampoa

Study Overview
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Brief Summary
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This study evaluates the Community for Successful Ageing (ComSA) Patient-Centered Medical Home (PCMH), a model of community-based primary care geriatric hub at Whampoa, Singapore.

Detailed Description
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This study evaluates the Community for Successful Ageing (ComSA) Patient-Centered Medical Home (PCMH), a model of community-based primary care geriatric hub at Whampoa, Singapore. This study aims to evaluate the impact of ComSA PCMH on health service utilisation, healthcare cost, clinical quality and effectiveness, as well as patient activation, quality of life, satisfaction and experience of care. The first component of the study is a single arm prospective pre-post cohort design, which aims to evaluate the impact on enrolled patients' self-reported health outcomes, experience of care, and cost effectiveness. The second component of the study evaluates the quality of the implementation processes via clinical quality indicators. The third component is a match-controlled retrospective pre-post study design, which aims to evaluate the impact on healthcare utilisation. Data sources include both survey data and administrative data.

Official Title
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The Community for Successful Ageing (ComSA) Patient-Centered Care (COPACC) Study: Utilization, Health and Economic Evaluation of a Community-Based Primary Care Geriatric Hub at Whampoa, Singapore.

Conditions
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Delivery of Health Care, Health Services, Costs and Cost Analysis, Quality of Life

Intervention / Treatment
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* Other: Patient-centred care home (PCMH)


Participation Criteria
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Eligibility Criteria
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Key inclusion criteria: i. Aged 40 years and above ii. Lives in Whampoa, Singapore iii. Enrolled in PCMH after 1 September 2017 Exclusion criteria: i. Aged less than 40 years ii. Does not live in Whampoa Singapore

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 99 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

| Intervention/Treatment |
| --- |
|Other: Patient-centred care home (PCMH)|New model of care defined by care provision by a team of people centered in the community that is both proactive and coordinated to improve the health and wellness of the people in that community.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Healthcare utilisation: Primary care | Primary care visits | Change from baseline to post-3 months, and to post-6 months | 
| Healthcare utilisation: Inpatient visits | Inpatient visits | Change from baseline to post-3 months, and to post-6 months | 
| Healthcare utilisation: Specialist outpatient care | Specialist outpatient clinic visits | Change from baseline to post-3 months, and to post-6 months | 
| Healthcare utilisation: A&E | A&E visits | Change from baseline to post-3 months, and to post-6 months | 
| Patient-reported outcome measure for patient activation | PAM-13 | Change from baseline to post-3 months, and to post-6 months | 
| Patient-reported outcome measure for quality of life | EQ-5D-5L | Change from baseline to post-3 months, and to post-6 months | 
| Patient-reported outcome measure for quality of life in old age | CASP-19 | Change from baseline to post-3 months, and to post-6 months | 
| Patient experience of care | CAHPS | 6 months | 
| Economic evaluation and cost analysis | Cost comparison between intervention group and non-intervention group | Change from baseline to post-3 months, and to post-6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patient-centred care, patient-centred medical home, older adults, complex needs, healthcare utilisation, economic evaluation, cost analysis, health services research