Protocol | Aims | Study design & Measurements | Intervention group | Comparator group | Expected outputs |
---|---|---|---|---|---|
(1) Population-based study | (1.1) Impact of integrated care on cost-effectiveness | (1.1) Case control study matching registry data using PSM methods (2011–2017) (Additional file 1: Table S1) | (1.1 and 1.2) Residents living in the healthcare district of Barcelona-Esquerra (n = 516 K inhabitants) | (1.1 and 1.2) Residents living in the other 3 healthcare districts of Barcelona (~ 400 k inhabitants each), as well as the entire region of Catalonia (n = 7.5 M inhabitants) | (1.1a) Health value generation of integrated care |
(1.2) Enhanced health risk assessment and service selection | (1.2) Fixed cohort study | (1.1b) Enhanced Key Performance Indicators (KPI) for long-term assessment of integrated care | |||
(1.2) Proposal for health risk assessment for service selection | |||||
(2) Home hospitalization | (2.1) Assessment of hospital avoidance and early hospital discharge at district level | (2.1) Prospective controlled cohort study using PSM methods (2017–2018) (Additional file 2: Table S2) | (2.1) All patients admitted to the home hospitalization directly from the emergency room (n = 800 patients). Study of a deeply characterized subset (triple aim approach) of 200 patients. This subset will be used to generate (2.2). | (2.1) Patients admitted to conventional hospitalization directly from the emergency department of the same hospital (n = 800 patients). Study of a deeply characterized subset (triple aim approach) of 200 patients. This subset will be used to generate (2.2). | (2.1a) Health value generation of the service; expanded HDA using MCDA (n = 200). Factors modulating success of the implementation strategy. |
(2.2) Observational mixed-methods study combining network and cluster analyses with qualitative methodologies | |||||
(2.2) Recommendations for shared-care agreements between specialized and community-based care | |||||
(2.1b) KPI for service assessment | |||||
(2.2) Strategies for enhanced interactions between specialized-community-based care. | |||||
(3) Prehabilitation | (3.1) Sustainability (cost-effectiveness of prehabilitation at HCB | (3.1) Prospective controlled cohort study using PSM methods (2016–2018) (Additional file 3: Table S3) | (3.1) All candidates for major surgery at HCB receiving prehabilitation (n = 500) | (3.1) Candidates for major surgery at HCB receiving usual care in the same hospital (n = 250) | (3.1a) Health value generation of prehabilitation at HCB |
(3.2) Recommendations for transition toward a regional peri-operative care program | (3.2) Randomized controlled trial to assess peri-operative care | (3.2) Candidates for major surgery at HCB receiving peri-operative care (n = 60) | (3.1b) KPI for service assessment | ||
(3.3) Enhanced pre-operative risk assessment | (3.3) Fixed cohort study | (3.3) All surgical patients in the last 5 years at HCB | (3.2) Candidates for major surgery at HCB receiving usual care (n = 60) | ||
(3.2) Cost-effectiveness of peri-operative care and strategies for regional deployment. | |||||
(3.3) Risk assessment tool for personalized prehabilitation | |||||
(4) Frail elderly patients | (4.1) Assessment of community-based integrated care services for frail patients at BSA | (4.1) Prospective controlled cohort study using PSM methods (2018) (Additional file 4: Table S4) | (4.1) Individuals enrolled in BSA integrated care programs for frail elderly that includes: i) Early Discharge support (n = 144); ii) Long-term home-based support services (n = 566) and iii) Geriatric residences care (n = 920) | (4.1) Individuals living in Badalona receiving usual care: i) After hospital discharge (n = 144), ii) At home (n = 566); and, iii) Living at geriatric residences (n = 920) | (4.1a) Cost-effectiveness of the service; and, expanded HDA using MCDA (n = 250). Factors modulating success of the implementation strategy. |
(4.1b) KPI for service assessment |