ArticleJournal of the American Geriatrics Society2021
Proactive primary care model for frail older people in New Zealand delays aged-residential care: A quasi-experiment.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Health Care Use of Frail Older People: Follow-Up Outcome Evaluation of an Intensive Primary Care Programme at 24 and 36 Months.Journal of the American Geriatrics Society · 2026Article
- Reimagining the frailty review: meaning, metrics, and the missed opportunity in global ageing care.Frontiers in medicine · 2025Article
- Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study.BMC geriatrics · 2024Article
- Article
- Impact of MidMed, a general practitioner-led modified comprehensive geriatric assessment for patients with frailty.Age and ageing · 2023Article
- Transitional care interventions to reduce emergency department visits in older adults: A systematic review.Belitung nursing journal · 2022Review
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesTo determine the effect of a proactive primary care program on acute hospitalization and aged-residential care placement for frail older people.
designControlled before and after, and controlled after only quasi-experimental studies, with a comparison group created via propensity score matching. One-year follow-up.
settingNine general practices in Auckland, New Zealand.
participantsCommunity-dwelling people aged 75 and older identified as at increased risk of hospitalization. One thousand and eighty five patients are compared with 3750 comparison patients matched by propensity score based on known risks.
interventionPrimary healthcare based, registered nurse-led, comprehensive geriatric assessment, goal-setting, care planning, and regular follow-up. Patients were also provided self-management education, health and social care navigation, and transitional care for hospital discharges. Practices received program support, workforce development, and mentoring of primary healthcare nurses by gerontology nurse specialists. MEASUREMENTS: Outcomes from routinely collected administrative data. Primary: aged-residential care placement. SECONDARY OUTCOMES: acute hospitalization, mortality, and other health service utilization.
resultsAged-residential care placement (odds ratio [OR] 0.66, 95% confidence interval (CI) = 0.48-0.91) and mortality (OR 0.66, 95% CI = 0.49-0.88) were significantly lower over the first year in Kare patients compared with matched controls. There was no difference in acute hospitalization (+0.06 admissions per year, 95% CI = -0.01-0.13). Support service use (allied health therapists and assessment for social support) was increased, and emergency department use decreased.
conclusionThe Kare participants had lower aged-residential care placement and mortality in the first year, but no decrease in acute hospitalization. Because the design is nonexperimental caution is required in interpreting these results.
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