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Trial record 1 of 69 for:    "social work" OR "social services" OR "social care" | Recruiting, Not yet recruiting Studies | First posted from 01/01/2017 to 08/18/2017
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Defining and Evaluating Norms for Health and Social Service (HASS) Use

This study is not yet open for participant recruitment.
Verified June 2017 by Dr. David Matchar, National University, Singapore
Sponsor:
ClinicalTrials.gov Identifier:
NCT03177200
First Posted: June 6, 2017
Last Update Posted: June 6, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Collaborators:
Ministry of Health, Singapore
Duke-NUS Medical School
Singapore General Hospital
Information provided by (Responsible Party):
Dr. David Matchar, National University, Singapore
  Purpose

Background In view of expected growth of the older population in Singapore in the next decades, the volume and complexity of needs for health care services is expected to increase, which amplifies stress on the current healthcare system. One approach to addressing this challenge is to consider service utilization in relationship to needs based on "population segmentation" and to plan and evaluate new services in light of unmet needs.

Specific Aims and Hypotheses Primary Aim 1: To establish health and social service (HASS) norms for population segments as defined by the Simple Segmentation Tool (SST) via a modified-Delphi methodology.

Primary Aim 2: To evaluate the concordance between the types of HASS that patients in each population segment actually utilize versus the types of HASS normatively defined for each population segment over a 3-month period from the point of hospital discharge.

Primary Hypothesis: The concordance between the actual utilization of different types of HASS versus normative HASS is not better than fair.

Secondary Aim: To assess the association between concordance of normative HASS and incidence of adverse outcomes which includes emergency department visits, unplanned hospital readmissions, nursing home placement, and all-cause mortality over a 12-month period from point of hospital discharge for all population segments.

Secondary Hypothesis: Patients with disagreement between normative HASS and actual utilization of HASS will have a higher incidence of adverse outcomes.

Methodology The investigators will use a modified-Delphi methodology to develop HASS norms and conduct a follow-up study of inpatients to evaluate the concordance between the types of HASS utilized and norm HASS, and to evaluate the association between this concordance and adverse outcomes in each population segment.

Significance to Health Services Delivery The transformation of the health care system to effectively meet growing needs in a patient-centric way requires practical tools for population planning and program development. The norms and evaluation approaches developed here will guide clinical and public policy decision makers in prioritizing population needs, and thus contribute to tangible improvements in health services delivery, patient care and health outcomes for an aging Singapore population.


Condition
Health and Social Services Population Segmentation Healthcare

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Defining and Evaluating Norms for Health and Social Service (HASS) Use for Population Health Segments

Further study details as provided by Dr. David Matchar, National University, Singapore:

Primary Outcome Measures:
  • Health and social service (HASS) norms for population segments [ Time Frame: 5 months ]

    HASS norms for population segments as defined by the Simple Segmentation Tool (SST) will be established via a modified-Delphi methodology analogous to that used in the RAND Appropriateness Initiative. The exercise will consist of two rounds of rating - an independent rating round and a group meeting to reconcile the results.

    The value of each indication by circling a number from 1 to 9 (1 being definitely not high value and 9 being definitely high value). The median panel rating to identify agreement or disagreement for each indication. Agreement is reached when 2 or fewer panel members vote outside the 3-point region containing the median. Disagreement is determined when 3 or more panelists rated in each extreme (1-3 and 7-9).


  • Concordance between actual HASS utilization vs HASS norms [ Time Frame: Over a 3-month period from date of discharge ]
    Information on the types of HASS that patients in each population segment actually utilize will be compared against the types of HASS normatively defined for each population segment over a 3-month period from the point of hospital discharge to evaluate concordance between the two. Type of services, frequency of utilization, reasons for taking and not taking the prescribed services, service expenditure, and adverse outcomes will be collected.


Secondary Outcome Measures:
  • Association between concordance of normative HASS and incidence of adverse outcomes over a 12-month period from point of hospital discharge for all population segments. [ Time Frame: Over a 12-month period from date of discharge ]
    Adverse outcomes for the purpose of this study include emergency department visits, unplanned hospital readmissions, nursing home placement, and all-cause mortality. The association will be assessed by review of information from EMR, National Death Registry, MOH and survey results. The associated healthcare expenditure will be estimated to understand the economic burden of study participants.


Estimated Enrollment: 1007
Anticipated Study Start Date: July 2017
Estimated Study Completion Date: June 2019
Estimated Primary Completion Date: March 2018 (Final data collection date for primary outcome measure)
  Show Detailed Description

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   55 Years to 100 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Study participants will be recruited from inpatients in the Singapore General Hospital Department of Internal Medicine (SGH DIM) and categorized based on their health care needs using the SST.
Criteria

Inclusion Criteria:

  1. Provision of informed consent
  2. Currently hospitalized
  3. Age ≥ 55 years at time of recruitment
  4. Singaporean or Permanent Resident

Exclusion Criteria:

  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03177200


Contacts
Contact: Rita Sim, BSc 66012453 rita.sim@duke-nus.edu.sg

Sponsors and Collaborators
National University, Singapore
Ministry of Health, Singapore
Duke-NUS Medical School
Singapore General Hospital
Investigators
Principal Investigator: David B Matchar, MD Duke-NUS Medical School
Principal Investigator: Kok Seng Wong, MMed Singapore General Hospital
  More Information

Responsible Party: Dr. David Matchar, Professor and Director, Health Services & Systems Research, Duke-NUS Medical School, National University, Singapore
ClinicalTrials.gov Identifier: NCT03177200     History of Changes
Other Study ID Numbers: HSRGWS16Jul004
First Submitted: May 21, 2017
First Posted: June 6, 2017
Last Update Posted: June 6, 2017
Last Verified: June 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No