Status:
COMPLETED
Inter-Disciplinary Outpatient Care Model Providing Comprehensive Geriatric Assessment, Care-Coordination & Co-management
Lead Sponsor:
Miami VA Healthcare System
Conditions:
Veterans
Geriatric Assessment
Eligibility:
All Genders
65+ years
Brief Summary
The Department of Veterans Affairs' (VA) Home Based Primary Care (HBPC) program provides comprehensive care to its sickest, frailest Veterans with multiple complex chronic diseases. The HBPC program i...
Detailed Description
The intervention will consist of the following components: 1. Comprehensive Geriatric Assessment: A complete geriatric assessment using an interdisciplinary team (geriatrician, psychologist, social w...
Eligibility Criteria
Inclusion
- Hospitalization in prior 12-months
- Received post-acute care in prior 12-months (skilled nursing facility or skilled home health care)
- Two or more chronic conditions
- Two or more activity of daily living impairments or greater or equal to six Frailty Index score
- Less than or equal to 60 minutes of closest VA primary care site.
Exclusion
- Enrolled in Home Based Primary Care
- Using hospice Care
- Using palliative care
- In a foster home
- In a nursing home
Key Trial Info
Start Date :
April 16 2018
Trial Type :
OBSERVATIONAL
Allocation :
ACTUAL
End Date :
March 31 2022
Estimated Enrollment :
206 Patients enrolled
Trial Details
Trial ID
NCT04846049
Start Date
April 16 2018
End Date
March 31 2022
Last Update
August 23 2024
Active Locations (1)
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1
Miami VA Healthcare System
Miami, Florida, United States, 33125