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Sponsor study identifier
observational
220
1 country
1
Study Start
September 30, 2024
Actual (reported)Primary Completion
May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Study Completion
May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Every country in the world is experiencing growth in both the size and the proportion of older persons. As a result of the changes, the profile and needs of people with medical illnesses have evolved. How care is delivered to patients has to keep pace with these changes, or patients will experience poor care at high cost and not have their needs met. A new model of care has emerged to meet these challenges: Acute Medical Unit. Despite considerable investment and popularity of this model, questions remain: (i) Who benefits most from this care model? (ii) How may these models be most effectively implemented for the best results? (iii) How effective are these models? Singapore is well-placed to answer these questions with its national healthcare system and excellent research institutions. The investigators plan to study how effective the model is by comparing patients with similar profiles exposed to both these care models compared to how hospital care is usually provided, looking for four differences: (i) how long patients stay in hospital, (ii) how often they use the emergency department (iii) quality of health (iv) cost. Additionally, the investigators seek to characterise patterns of health needs for this group of patients.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
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Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
September 30, 2024
Actual (reported)January 25, 2026
Actual (reported)April 17, 2026
Actual (reported)May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Mean acute care bed-days utilised
Average total days of acute hospital stay, including the index episode, for each patient. Measures efficiency of hospital care between AMU and GW groups.
Up to 6 months following discharge
Patient Outcomes - Health-related Quality of Life (EQ-5D-5L)
Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient Outcomes - Patient Activation Measure (PAM-13)
Baseline (Day 0, at discharge) and 6 months post-discharge
Patients admitted to the AMU from the Emergency Department (ED) or specialist clinics as their first admission ward. The AMU provides rapid assessment and early intervention to improve efficiency of care. Participants will primarily include adults with acute medical illnesses such as infection-related conditions, falls/disequilibrium, or acute exacerbation of COPD.
Patients admitted directly from the ED to General Wards under the Division of Advanced Internal Medicine. Patients will be matched to the AMU group by diagnosis group, age, gender, illness severity, comorbidities, frailty, and functional status to minimize confounding factors.
The study population will consist of adult patients admitted to the National University Hospital (NUH), Singapore, for acute medical conditions. Participants will be recruited either from the Acute Medical Unit (AMU) or directly to the General Ward (GW) following presentation to the Emergency Department. Patients represent a typical mix of acute medical admissions seen in a tertiary hospital setting, including infection-related illnesses, falls with disequilibrium, and acute exacerbations of chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD).
National University Hospital
Singapore, 119228, Singapore
Lateef A, Lee SH, Fisher DA, Goh WP, Han HF, Segara UC, Sim TB, Mahadehvan M, Goh KT, Cheah N, Lim AYT, Phan PH, Merchant RA. Impact of inpatient Care in Emergency Department on outcomes: a quasi-experimental cohort study. BMC Health Serv Res. 2017 Aug 14;17(1):555. doi: 10.1186/s12913-017-2491-x.
Balakrishnan T, Teo PSE, Lim WT, Xin XH, Yuen BH, Wong KS. Acute Medical Ward for better care coordination of patients admitted with infection - evidence from a tertiary hospital in Singapore. Acute Med. 2017;16(4):170-176.
First Submitted
January 25, 2026
First Posted
April 17, 2026
Study Start
September 30, 2024
Actual (reported)Primary Completion
May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Patient Outcomes - World Health Organisation Five Wellbeing (WHO-5)
Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient Outcomes - Patient Health Questionnaire (PHQ-9)
Baseline (Day 0, at discharge) and 6 months post-discharge
Patient Outcomes - Functional Dependence (Barthel Index)
Baseline (Day 0, at discharge) and 6 months post-discharge
Cost-effectiveness
Up to 6 months from discharge
Contact the study team to confirm eligibility.
Reid LE, Dinesen LC, Jones MC, Morrison ZJ, Weir CJ, Lone NI. The effectiveness and variation of acute medical units: a systematic review. Int J Qual Health Care. 2016 Sep;28(4):433-46. doi: 10.1093/intqhc/mzw056. Epub 2016 Jun 16.
Soong JTY, Bell D, Ong MEH. Meeting today's healthcare needs: Medicine at the interface. Ann Acad Med Singap. 2022 Dec;51(12):787-792. doi: 10.47102/annals-acadmedsg.2022196.
Roseveare C. Acute medicine and general practice: a key interface in managing emergency care pressures. Br J Gen Pract. 2014 Mar;64(620):122-3. doi: 10.3399/bjgp14X677392. No abstract available.
Soong JTY, Valderas JM, Bell D, Ghandi M, Graves N, Ong M. Clinical and cost-effectiveness of an acute medical unit model in Singapore: protocol for a pilot prospective cohort study. BMJ Open. 2026 Jul 27;16(7):e121444. doi: 10.1136/bmjopen-2026-121444.
Study Completion
May 31, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Last Updated
April 17, 2026
Record last verified: 2025-09
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