Randomized Controlled Trial of Health Care to Elderly Patients.

• Number of readmissions [ Time Frame: Within 60 days ] [ Designated as safety issue: No ]
• Number of deaths [ Time Frame: Within 12 months ] [ Designated as safety issue: No ]
• Need of home nursing services [ Time Frame: within 12 months ] [ Designated as safety issue: No ]

• Number of days initially hospitalized
• Number of deaths within six months and one year
• Need of home nursing services after six and twelve months
• Number of readmisisons within 60 days

To study the efficacy of multicomponent treatment and care for patients with acute illness or deterioration of a chronic disease at a nursing home in primary health care compared to traditional treatment at hospital.

Managers at St. Olavs University Hospital and the City of Trondheim local authority decided in 2001 to establish a reinforced department at a nursing home with a multicomponent approach to patient treatment.

In the study treatment at a nursing home will be compared with conventional treatment in ordinary hospital beds in medical, surgical and orthopedic departments at a hospital. Participating doctors at the hospital together with general practitioners shall develope inclusion criteria through Delphi technique. Eligible participants will be hospitalized from their ordinary home and expected to return to home after treatment. When an eligible patient is identified and accepted for inclusion, randomization will be performed by the Clinical Research Department at the Faculty of Medicine.

• Congestive Heart Failure
• Angina Pectoris
• Asthma
• Pneumonia
• Fractures

• Other: Multicomponent treatment
  Specialized care in preparing recharge to home
• Other: usual care
  Usual recharge directly from hospital to home

• Experimental: Intermediate community hospital
  Intervention: Other: Multicomponent treatment
• Active Comparator: Usual care
  Intervention: Other: usual care

• Garåsen H, Windspoll R, Johnsen R. Intermediate care at a community hospital as an alternative to prolonged general hospital care for elderly patients: a randomised controlled trial. BMC Public Health. 2007 May 2;7:68.
• Garåsen H, Magnussen J, Windspoll R, Johnsen R. [Elderly patients in hospital or in an intermediate nursing home department--cost analysis]. Tidsskr Nor Laegeforen. 2008 Jan 31;128(3):283-5. Norwegian.
• Garåsen H, Windspoll R, Johnsen R. Long-term patients' outcomes after intermediate care at a community hospital for elderly patients: 12-month follow-up of a randomized controlled trial. Scand J Public Health. 2008 Mar;36(2):197-204.
• Garåsen H, Johnsen R. The quality of communication about older patients between hospital physicians and general practitioners: a panel study assessment. BMC Health Serv Res. 2007 Aug 24;7:133.

Inclusion Criteria:

• Participating doctors at the hospital together with general practitioners shall develope inclusion criteria through Delphi technique.

Exclusion Criteria:

• Participating doctors at the hospital together with general practitioners shall develope exclusion criteria through Delphi technique.