Prof. dr. S.E.J.A. de Rooij
Academisch Medisch Centrum
Hospital At Home care program for patients with dementia and an acute medical crisis
Alzheimer's disease & other dementias
OBJECTIVE: The H@H trial investigates the balance of costs and clinical effects in terms of complications and mortality between H@H care
and conventional hospital care
H@H care reduces costs, complications and mortality in dementia patients admitted to the ED for hospitalization with selected
acute medical illnesses who require acute hospital-level care.
Multicentre randomized controlled, parallel-group superiority trial.
STUDY POPULATION: In total 266 patients aged 65 years or above, known with a diagnosed dementia syndrome.
INTERVENTION: H@H vs conventional hospital care.
OUTCOME MEASURES: Primary endpoint: composite endpoint of severe complications (readmission to hospital) and mortality within 6 months after randomisation.
Secondary endpoints: costs, budget impact, functional status and functional decline, quality of life in terms of quality-adjusted life years (QALYs), incidence of all individual components of the primary endpoint, admission to nursing home, length of hospital stay after readmission, new onset intensive care admission, length of intensive care stay, any complications [falls, new infections], number of endoscopic, radiological and operative (re-) interventions.
COST-EFFECTIVENESS AND BUDGET IMPACT ANALYSIS
Cost-effectiveness and cost-utility analyses from a societal perspective with the costs per patient with poor outcome (severe complications and/or death) and costs per QALY as primary outcome measures respectively. Budget impact analyses from governmental, insurer, and provider perspectives.