TY - JOUR
T1 - Effect of telecare on use of health and social care services
T2 - Findings from the Whole Systems Demonstrator cluster randomised trial
AU - Steventon, Adam
AU - Bardsley, Martin
AU - Billings, John
AU - Dixon, Jennifer
AU - Doll, Helen
AU - Beynon, Michelle
AU - Hirani, Shashi
AU - Cartwright, Martin
AU - Rixon, Lorna
AU - Knapp, Martin
AU - Henderson, Catherine
AU - Rogers, Anne
AU - Hendy, Jane
AU - Fitzpatrick, Ray
AU - Newman, Stanton
N1 - Funding Information:
The study was funded by the Department of Health in England. The Department of Health reviewed the protocol for the study and provided project manager support for the implementation of telecare. The University College London Hospitals and University College London were the Whole Systems Demonstrator study sponsors. Their role as sponsors was to ensure that the study was conducted in accordance with the Research Governance Framework for Health and Social Care (2nd edition, April 2005) and to confirm that arrangements were in place for the initiation, management, monitoring and financing of the trial.
PY - 2013/7
Y1 - 2013/7
N2 - Objective: to assess the impact of telecare on the use of social and health care. Part of the evaluation of the Whole Systems Demonstrator trial. Participants and setting: a total of 2,600 people with social care needs were recruited from 217 general practices in three areas in England. Design: a cluster randomised trial comparing telecare with usual care, general practice being the unit of randomisation. Participants were followed up for 12 months and analyses were conducted as intention-to-treat. Data sources: trial data were linked at the person level to administrative datasets on care funded at least in part by local authorities or the National Health Service. Main outcome measures: the proportion of people admitted to hospital within 12 months. Secondary endpointsincluded mortality, rates of secondary care use (seven different metrics), contacts with general practitioners and practice nurses, proportion of people admitted to permanent residential or nursing care, weeks in domiciliary social care and notional costs. Results: 46.8% of intervention participants were admitted to hospital, compared with 49.2% of controls. Unadjusted differences were notstatistically significant (odds ratio: 0.90, 95% CI: 0.75-1.07, P = 0.211). They reached statistical significance after adjusting for baseline covariates, but this was not replicated when adjusting for the predictive risk score. Secondary metrics including impacts on social care use were not statistically significant. Conclusions: telecare as implemented in the Whole Systems Demonstrator trial did not lead to significant reductions in service use, at least in terms of results assessed over 12 months. International Standard Randomised Controlled Trial Number Register ISRCTN43002091.
AB - Objective: to assess the impact of telecare on the use of social and health care. Part of the evaluation of the Whole Systems Demonstrator trial. Participants and setting: a total of 2,600 people with social care needs were recruited from 217 general practices in three areas in England. Design: a cluster randomised trial comparing telecare with usual care, general practice being the unit of randomisation. Participants were followed up for 12 months and analyses were conducted as intention-to-treat. Data sources: trial data were linked at the person level to administrative datasets on care funded at least in part by local authorities or the National Health Service. Main outcome measures: the proportion of people admitted to hospital within 12 months. Secondary endpointsincluded mortality, rates of secondary care use (seven different metrics), contacts with general practitioners and practice nurses, proportion of people admitted to permanent residential or nursing care, weeks in domiciliary social care and notional costs. Results: 46.8% of intervention participants were admitted to hospital, compared with 49.2% of controls. Unadjusted differences were notstatistically significant (odds ratio: 0.90, 95% CI: 0.75-1.07, P = 0.211). They reached statistical significance after adjusting for baseline covariates, but this was not replicated when adjusting for the predictive risk score. Secondary metrics including impacts on social care use were not statistically significant. Conclusions: telecare as implemented in the Whole Systems Demonstrator trial did not lead to significant reductions in service use, at least in terms of results assessed over 12 months. International Standard Randomised Controlled Trial Number Register ISRCTN43002091.
KW - Administrative data
KW - Assistive technology
KW - Older people
KW - Randomised controlled trial
KW - Telecare
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U2 - 10.1093/ageing/aft008
DO - 10.1093/ageing/aft008
M3 - Article
C2 - 23443509
AN - SCOPUS:84879871453
SN - 0002-0729
VL - 42
SP - 501
EP - 508
JO - Age and Ageing
JF - Age and Ageing
IS - 4
ER -