Home-Based Clinical Assessment by Municipal Acute Care Teams with Remote Physician Consultation Compared to Standard Care to Reduce Hospital Admissions Among Nursing Home Residents

What this Trial Is About

This research aims to evaluate whether clinical assessments conducted at nursing homes by municipal acute care teams, combined with remote consultations with senior hospital physicians, can safely reduce hospital admissions and mortality among nursing home residents experiencing acute illness or deterioration during out-of-hours periods. The study involves nursing homes in the Capital Region of Denmark and compares this new care model to usual care, which involves contacting a regional medical helpline. Nursing home residents are often frail with multiple chronic conditions and face risks of complications from hospital stays, which this study seeks to address by providing timely care in familiar surroundings. Participants are nursing homes randomized to either an intervention group, where nursing home staff contact municipal acute care teams directly during out-of-hours for urgent assessments, or a control group following usual care by calling the regional medical helpline. The acute care teams perform on-site assessments and consult senior physicians remotely when needed to develop treatment or observation plans. Possible care outcomes include management at the nursing home, hospital-at-home treatment, outpatient hospital assessment, mobile physician visits, or hospital admission. The study includes a run-in period to optimize the intervention before the main data collection. Participants health data, including mortality and hospital admission timing up to 48 weeks, are collected by hospital physicians. Nurses document initial care decisions and follow-up data. The study also tracks emergency contacts and healthcare costs per resident. Data analysis will assess clinical outcomes and cost implications of the intervention. The total study duration spans from February 2026 to December 2027 with ongoing monitoring throughout the period.

Clinical Assessment and Treatment in the Nursing Home as an Alternative to Hospital Admission