Clinical Assessment and Treatment in the Nursing Home as an Alternative to Hospital Admission
Home-Based Assessment and Treatment by Municipal Acute Care Teams Combined With Remote Senior Physician Consultation as an Alternative to Hospital Admission for Nursing Home Residents: A Multicenter Randomized Controlled Trial
1 other identifier
interventional
9,000
1 country
4
Brief Summary
This multicenter, cluster-randomized, unblinded quality-improvement study evaluates whether home-based clinical assessment by municipal acute care teams can safely reduce hospital admissions among nursing home residents experiencing acute illness or clinical deterioration during out-of-hours periods. Participating nursing homes in the Capital Region of Denmark will be randomized to either usual care (contacting the regional medical helpline, 1813) or the intervention pathway, in which nursing home staff contact a municipal acute care team directly. The acute care team performs an on-site clinical assessment and, when needed, consults a senior physician in the hospital emergency department to establish a treatment and observation plan, which may include continued management at the nursing home under hospital responsibility. The study compares the intervention with usual care with respect to hospital admissions and mortality among nursing home residents.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Feb 2026
Typical duration for not_applicable
4 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
February 1, 2026
CompletedFirst Submitted
Initial submission to the registry
August 3, 2026
CompletedFirst Posted
Study publicly available on registry
August 10, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
June 1, 2027
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 1, 2027
August 10, 2026
August 1, 2026
1.3 years
August 3, 2026
August 6, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
All-cause mortality
Time to death from any cause, compared between intervention and usual care groups using time-to-event methods.
From date of randomization until date of death from any cause, up to 48 weeks.
Time to first hospital admission
Time to first acute hospital admission, compared between intervention and usual care groups using time-to-event methods.
From date of randomization until the date of first acute admission to emergency department or hospital, up to 48 weeks.
Secondary Outcomes (3)
Initial Disposition After Assessment by the Municipal Acute Care Team
At completion of the index assessment, up to 6 hours.
Number of emergency contacts (both groups)
From date of randomization until the end of follow-up, up to 48 weeks.
Total healthcare cost per nursing home resident
From date of randomization until the end of follow-up, up to 48 weeks.
Other Outcomes (2)
Nursing home resident experience (qualitative)
One month after clinical assessment
Healthcare personal experience (qualitative)
6 months after enrollment of nursing home
Study Arms (2)
Home-based assessment and treatment
EXPERIMENTALThe intervention group
Standard care
NO INTERVENTIONThe control group
Interventions
Nursing homes in the intervention group will, if a resident experiences acute illness or clinical deterioration, call the municipal acute care team directly. They will then do a home-based clinical assessment and, if deemed necessary, consult a senior physician in the hospital emergency or geriatrics department to establish a treatment and observation plan.
Eligibility Criteria
You may qualify if:
- Nursing homes, defined as long-term care facilities with care personnal available 24/7 for residents with need for continued medical care
- Nursing homes located in the Capital Region of Denmark
- Nursing homes accepting participation and cluster randomization
You may not qualify if:
- Assisted living facilities, intermediate/temporary care units, rehabilitation units, hospices, or other non-nursing-home setting.
- Nursing homes located on the island of Bornholm
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Copenhagen University Hospital at Herlevlead
- Herlev and Gentofte Hospitalcollaborator
- Amager Hospitalcollaborator
- Bispebjerg Hospitalcollaborator
- Nordsjaellands Hospitalcollaborator
Study Sites (4)
Copenhagen University Hospital - Bispebjerg and Frederiksb
Copenhagen, Denmark
University Hospital of Copenhagen Herlev
Herlev, Denmark
Copenhagen University Hospital - North Zealand Hospital
Hillerød, Denmark
University Hospital of Copenhagen Amager and Hvidovre
Hvidovre, Denmark
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Study Officials
- STUDY CHAIR
Kasper K Iversen, MD, Professor
University Hospital of Copenhagen Herlev and Gentofte
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
August 3, 2026
First Posted
August 10, 2026
Study Start
February 1, 2026
Primary Completion (Estimated)
June 1, 2027
Study Completion (Estimated)
December 1, 2027
Last Updated
August 10, 2026
Record last verified: 2026-08