Secure And Focused primary care for older pEople (SAFE) - A prospective matched-controlled trial

Research problem and specific questionsThe demographic change with an aging population is a challenge for healthcare and highlights the need for effective, proactive care models in primary care to maintain health, functional capacity and autonomy in old age.

Comprehensive Geriatric Assessment (CGA) is a team-based care model for structured assessment and comprehensive follow-up of older patients.

Larger studies of CGA in primary care are however lacking.Overall research questionCan a proactive work model with CGA and coordinated care in primary care reduce the need for inpatient care among older people with increased risk of hospitalization?Specific questionsDoes the proactive work model contribute to strengthened or maintained autonomy, health and functional ability in older people?What are the health economic effects/cost-effectiveness of the work model?Does the care model affect the content, quality and/or participation the care planning?Does a structured way of working strengthen self-efficacy and the sense of security among older people?Data and methodSAFE is a prospective, multicenter study that is ongoing in two regions in Sweden; at 26 interventional and 25 matched control care centers.

Study participants are identified via a validated risk prediction model.

Community-dwelling persons who are older than 75-years and within the 15% highest risk values are offered participation. The participants are followed for 24 months. Primary outcome measure is number of inpatient days. To answer the research questions, mixed methods are used where quantitative and qualitative sub-studies are included.

Data is collected via registries and care data warehouses, questionnaires and interviews.

This combination of methods and different data sources provides a comprehensive coverage of the data needed to answer the questions.Societal relevance and utilisationEarly identification of older people with an increased risk of future hospital admissions and providing proactive and effective care is of utmost importance, both on an individual person level as well as for the healthcare system.

Plan for project realisationThe SAFE study is conducted as a prospective, multicenter study with matched controls. Inclusion of participants in the SAFE study began in the spring of 2023. The two-year follow-up will begin in April 2025.

We apply for a total of three million SEK for the remaining parts of the data collection, data analysis and dissemination of results.