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Implementation and effectiveness of 'care navigation', coordinated management for people with complex chronic illness: rationale and methods of a randomised controlled trial

Overview of attention for article published in BMC Health Services Research, May 2013
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1 tweeter

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Title
Implementation and effectiveness of 'care navigation', coordinated management for people with complex chronic illness: rationale and methods of a randomised controlled trial
Published in
BMC Health Services Research, May 2013
DOI 10.1186/1472-6963-13-164
Pubmed ID
Authors

Natalie Plant, Kylie-Ann Mallitt, Patrick J Kelly, Tim Usherwood, James Gillespie, Steven Boyages, Stephen Jan, Justin McNab, Beverley M Essue, Kathy Gradidge, Nereus Maranan, David Ralphs, Clive Aspin, Stephen Leeder

Abstract

BACKGROUND: Chronic illness is a significant driver of the global burden of disease and associated health care costs. People living with severe chronic illness are heavy users of acute hospital services; better coordination of their care could potentially improve health outcomes while reducing hospital use. The Care Navigation trial will evaluate an in-hospital coordinated care intervention on health service use and quality of life in chronically ill patients.Methods/design: A randomised controlled trial in 500 chronically ill patients presenting to the emergency department of a hospital in Western Sydney, Australia. Participants have three or more hospital admissions within a previous 12 month period and either aged >=70 years; or aged >=45 years and of Aboriginal or Torres Strait Islander descent; or aged >= 16 with a diagnosis of a respiratory or cardiology related illness. Patients are randomised to either the coordinated care program (Care Navigation), or to usual care. The Care Navigation program consists of dedicated nurses who conduct patient risk assessments, oversee patient nursing while in hospital, and guide development of a care plan for the management of chronic illness after being discharged from hospital. These nurses also book community appointments and liaise with general practitioners. The main outcome variables are the number of emergency department re-presentations and hospital readmissions, and quality of life during a 24 month follow-up. Secondary outcomes are length of hospital stay, mortality, time to first hospital re-admission, time to first emergency department re-presentation, patient satisfaction, adherence to prescribed medications, amount and type of in-hospital referrals made for consultations and diagnostic testing, and the number and type of community health referrals. A process evaluation and economic analysis will be conducted alongside the randomised trial. DISCUSSION: A trial of in-hospital care coordination may support recent evidence that engaging primary health services in care plans linked to multidisciplinary team support improves patient outcomes and reduces costs to the health system. This will inform local, national and international health policy.Trial registration: Australia New Zealand Clinical Trials Registry ACTRN12609000554268.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 194 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 2 1%
Australia 1 <1%
Indonesia 1 <1%
Mexico 1 <1%
Canada 1 <1%
Unknown 188 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 32 16%
Student > Ph. D. Student 26 13%
Researcher 19 10%
Student > Bachelor 18 9%
Student > Doctoral Student 12 6%
Other 50 26%
Unknown 37 19%
Readers by discipline Count As %
Medicine and Dentistry 53 27%
Nursing and Health Professions 41 21%
Social Sciences 16 8%
Psychology 9 5%
Unspecified 9 5%
Other 27 14%
Unknown 39 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 May 2013.
All research outputs
#15,271,180
of 22,709,015 outputs
Outputs from BMC Health Services Research
#5,537
of 7,594 outputs
Outputs of similar age
#119,423
of 192,813 outputs
Outputs of similar age from BMC Health Services Research
#90
of 114 outputs
Altmetric has tracked 22,709,015 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,594 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one is in the 17th percentile – i.e., 17% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 192,813 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 114 others from the same source and published within six weeks on either side of this one. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.