The project aims to use multidimensional prognostic indices(MPI)that predict survival, based on a Comprehensive Geriatric Assessment (CGA), to improve the cost-effectiveness of health interventions in older individuals with multimorbidity and polypharmacy. The best setting-specific MPI-profile in which individual interventions are effective and reference models for allocate resources in healthcare will be identified to promote integrated care pathways of interventions.
The general objective is to reduce unnecessary use of health care resources according to appropriate and tailored, integrated multi-professional, planned interventions to the older subjects.
The strategic relevance of the project is related to decreasing health-related costs while increasing cost-effectiveness of interventions, in order to assure an appropriate distribution of health resources according to the health needs of the older subjects. According to the Innovation Union Communication (IUC) launched by the Commission in 2010, the multidimensional, multidisciplinary and predictive strategies proposed by the project give relevant contribution to the EC programme in creating common and shared solutions that are closed to the specific needs of the aging population. Moreover the core activities of the project relate specifically to generating and disseminating health information and knowledge seeking to create evidence for policy makers and translating clinical practice into policy strategy that represents one of the 3 principal objectives of the second programme of Community action in the field of health (2008-13).
A web platform that facilitates the communication and monitoring of the activities among partners will be developed. In WP4 a retrospective analysis on the use of predictive rules in community-dwelling older subjects will be performed using clinical, functional and administrative data. In WP5 the best cost-effective profile of different therapeutic interventions in older individuals with different MPI-based mortality-risk profile will be identified. Specific activities of WP4 and WP5 will be addressed to identify the MPI-profiles that allow the development of the most cost-effective individual interventions to reduce adverse outcomes. In WP6 about 1000 subjects of both genders will be prospectively recruited in 10 clinical centers. Efficacy of interventions will be evaluated after 12 months of follow-up. A systematic process of dissemination and recommendations will be complete through the wide involvement of partners, external experts and stakeholders in meetings and web diffusion.
1) Identifying the most effective interventions according to the multidimensional prognostic life-expectancy profile;
2) Improving multi-professional interaction and collaboration in performing shared multidimensional integrated care pathways of interventions;
3) Reducing hospitalization and institutionalization rates;
4) Reducing inappropriate and unnecessary drug use;
5) Reducing costs related to hospitalization or institutionalization.