Helge Garåsen The Trondheim Model - NSDM

Main conclusions study II:
1. Care at intermediate level at a community hospital was cost effective from a health
service perspective and gives better patient outcome as more patients had a better
functional status and significantly fewer patients were dead after 12 months of followup.
2. It is mandatory to establish better after-care services for older patients admitted to
general hospitals as a step-down care between home care and specialised general
hospital care.
8.0 Suggestions for further research
8.1. Study I
- There are so far no models for communication between physicians at primary and
secondary level securing sufficient quality when exchanging medical information, and
trials have to be performed on new core electronic health record systems (175):
o to test different models for exchanging vital information
o to establish consensus on what vital information is
o to test models to access necessary basic health information in emergency
situations
8.1. Study II
- There is little existing scientific evidence as to the benefits of intermediate care and
more randomised controlled trials are necessary to test different models for intermediate
care at community hospitals and hospital at home regimes (176):
o As alternatives to general hospital admissions
o As alternatives to prolonged general hospital care
- Additionally, the economic consequences of different intermediate models have to be
explored.
- Further randomised controlled trials are necessary to test which parts of intermediate
care are essential to achieve the best patients’ outcomes.
- The present study should be repeated to test if the results are reproducible in other
settings.
83