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NCT Number: NCT07536035

Potential of Interface Care Models to Deliver More Appropriate Care to Patients With Acute Medical Illness

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.

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Key information

Conditions

Falls Injury Acute Exacerbation of Asthma Chronic Disease Chronic Obstructive Pulmonary Disease (COPD) Disease Attributes Falls Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Hospitalization in Acute Care Infection Infections Lung Diseases Lung Diseases, Obstructive Male Urogenital Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Pneumonia Pulmonary Disease, Chronic Obstructive Respiratory Tract Diseases Respiratory Tract Infections URTI - Viral Upper Respiratory Tract Infection UTI - Urinary Tract Infection Urinary Tract Infections Urogenital Diseases Urologic Diseases

Age range

21 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

National University Hospital

Singapore, 119228

Location status: Recruiting

Location contact

John TY Soong, PhD

CONTACT

[email protected]

+6567727678

John TY Soong, PhD

PRINCIPAL_INVESTIGATOR

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • AMU inclusion criteria - admission from ED to AMU directly
  • Control group inclusion criteria - admission from ED to GW directly
  • Acute medical illnesses that includes infection-related conditions, falls-disequilibrium, and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).

Exclusion criteria

  • Below 21 years old
  • Patients undergoing active chemotherapy
  • Patients with active pregnancy
  • Patients admitted less than 24 hours
  • Cerebrovascular disease requiring thrombolysis or intravascular intervention

Treatment and study plan

Primary outcomes

  1. Mean acute care bed-days utilised

    Time frame: Up to 6 months following discharge

    Average total days of acute hospital stay, including the index episode, for each patient. Measures efficiency of hospital care between AMU and GW groups.

Secondary outcomes

  1. Patient Outcomes - Health-related Quality of Life (EQ-5D-5L)

    Time frame: Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge

    Patients rate 5 areas - mobility, self-care, usual activities, pain/discomfort, and anxiety/depression on a 5-level scale from 1 (no problems) to 5 (extreme problems). Scores are combined into an overall health index, where higher scores indicate worse health status. This captures the patient's overall quality of life over the follow-up period.

  2. Patient Outcomes - Patient Activation Measure (PAM-13)

    Time frame: Baseline (Day 0, at discharge) and 6 months post-discharge

    Patients answer 13 questions on a 4-point scale from "strongly disagree" to "strongly agree," with a "not applicable" option. Raw scores are converted to a 0-100 scale, where higher scores indicate greater engagement in self-care. Scores classify patients into four levels: Level 1 = disengaged, Level 2 = gaining confidence, Level 3 = taking action, Level 4 = confident and maintaining self-management.

  3. Patient Outcomes - World Health Organisation Five Wellbeing (WHO-5)

    Time frame: Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge

    Patient answers five questions that assess mood, energy, and interest in daily life over the past two weeks, scored 0 (at no time) to 5 (all of the time). The total score (0-25) is multiplied by 4 to create a 0-100 scale, where higher scores indicate better wellbeing.

  4. Patient Outcomes - Patient Health Questionnaire (PHQ-9)

    Time frame: Baseline (Day 0, at discharge) and 6 months post-discharge

    PHQ-9 includes 9 items scored 0 (not at all) to 3 (nearly every day), total 0-27; higher scores indicate more severe depressive symptoms.

  5. Patient Outcomes - Functional Dependence (Barthel Index)

    Time frame: Baseline (Day 0, at discharge) and 6 months post-discharge

    Measures independence in 10 daily activities, scored 0 (fully dependent) to 100 (fully independent). Higher scores indicate greater ability to perform daily activities without assistance.

  6. System Outcomes - Number of Emergency Department (ED) visits

    Time frame: Baseline (Day 0, at discharge) and 6 months post-discharge

    Number of ED visits recorded in hospital records within 6 months. Higher counts reflect greater acute care needs.

  7. System Outcomes - Specialist Outpatient Clinic visit

    Time frame: Baseline (Day 0, at discharge) and 6 months post-discharge

    Number of outpatient specialist visits, as recorded in hospital system.

  8. System Outcomes - Polyclinic Visits

    Time frame: Baseline (Day 0, at discharge) and 6 months post-discharge

    Number of visits to public polyclinics captured through health records

  9. System Outcomes - Hospital Admissions

    Time frame: 6 months post-discharge

    Number of inpatient hospital admissions during follow-up, excluding the index admission.

Other outcomes

  1. Cost-effectiveness

    Time frame: Up to 6 months from discharge

    Estimate the change to 'total costs' and the change to 'health benefits' as measured by Quality Adjusted Life Years (QALYS) from a decision to adopt AMU as compared to the 'existing acute care chain' in Singapore

Study contacts

Contact information is provided by the study sponsor or research team.

John TY Soong, PhD

CONTACT

[email protected]

+6567727678

Sponsors and collaborators

Lead sponsor

National University Hospital, Singapore

Other

Collaborators

  • Duke-NUS Graduate Medical School

Registry information

Official study title

Potential of Interface Care Models to Deliver More Appropriate Care to Patients With Acute Medical Illness in Singapore and Decrease Utilisation of Acute Care Bed-days

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Apr 17, 2026
Registry last updated
Apr 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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