Helge Garåsen The Trondheim Model - NSDM

- Estimate the proportion of patients that could have been treated without being admitted
to a general hospital; i.e. provided care by home care, in nursing homes, at outpatient
clinics or by general practitioners.
- Identify specific patient groups where care outside a general hospital department might
be possible.
3. Through a randomised controlled trial evaluate the short and long term effects on
patients’ outcome of intermediate care at a community hospital compared to standard
prolonged care at general hospital.
4. Through a randomised controlled trial estimate if care provided at an intermediate level
is cost effective in a health service perspective compared to standard prolonged care at
a general hospital.
3.2 Hypothesis
The study was designed to test the following hypotheses:
1. Referral and discharge letters between physicians contain necessary and sufficient
information to secure optimal patient care when transferring duties and obligations
from one responsible person or medical team to another.
2. The number of unnecessary referrals of older patients to the general hospital is sparse,
and there are no specific patient groups where care can be provided at primary level
instead of at a general hospital.
3. Multicomponent care at an intermediate level at a community hospital will:
- reduce morbidity assessed as number of readmissions
- reduce the need for home care
- reduce the need for long-term nursing homes
- without to increase mortality
- without to increase the number of days of inpatient care
- provide care at a lower cost per patient
4.0 Patients and Methods
4.1.0 Study population. Study I - The quality of written communication
between a general hospital and general practitioners
During a period of three weeks in February 2002 referral and discharge letters for 100
patients, both acute and elective, were included into the study. Patients 75 years or older from
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