Short summary

The political system in Denmark wishes to strengthen the efforts for more continuum of care for the elderly and to make them a co-developer of the health care system.

This PhD aims to contribute with new knowledge about the elderlys' perspective on continuum of care, how they experience the collaboration between health care sectors and on how they can and will be a co-developer. Recommendations on how to strengthen the health care system from the elderly perspectives will be made. 

Rationale

"AT FRONT EDGE" is a large research cooperation between the Hospital of Southern Jutland, the general practitioners, the municipalities of Haderslev, Toender, Soenderborg, Aabenraa, University Collage South and several research units at SDU. 

Based on the acute admitted elderly patients, their relatives and the health professionals perspectives, the overall purpose of the "AT FRONT EDGE " project is to develop and implement actions that will create more good years of life for the elderly, increase the elderly's functioning and quality of life and reduce or delay the number of admissions. In order to illuminate all these perspectives, the first phases are built on four PhDs. projects. They have each their perspective, the perspectives of the older citizen, their relatives, the health professionals and a quality of life perspective. In later phases, other PhD projects highlight the overall effect of the changes, including the health-economic aspects of the whole area.

Involvement of patients and quality improvement across sectors, as well as focus on efforts towards the elderly, has been on the political agenda for several years in Denmark. In 2016, the Ministry of Health and the five Danish Regions and the Association of the Danish municipalities, elaborated the eight "National Health Care Objectives", where several good years of living, better coherent progress, strengthened efforts for the elderly patient and more effective health care were among other things in focus. The objectives put the patient at the center, pointing out that a local commitment to quality work should improve these goals. At the same time, the National Board of Health wishes to strengthen the efforts of the elderly medical patient and strengthen the Continuum of Care made between their hospitals, municipalities and the general practitioners. There is also political desire for user involvement in the development of the Health Care system.

It is therefore relevant to research the perspectives of the acute admitted elderly patients and how we can incorporate these perspectives to strengthen and develop the Health Care system in Denmark and this PhD project aims to contribute with this knowledge and recommendations from the elderlys perspectives will be made. 

Description of the cohort

Patients will be recruited at the Emergency department at the Hospital of Southern Jutland. A least 12 patients at the aged of 75 years and above will participate. The aim is to recruit an equal number of men and women, and that each of the four municipalities is represented with a fair number of participants.   

Data and biological material

Patients will be interviewed the first time at their acute admission to the hospital. Four till six weeks after their discharged the participant will be interviewed a second time in their home. A third interview may be held six month after their discharged.

The participants will be interviewed about their experiences and attitudes towards continuum of care and towards the cooperation between the hospital, the municipality, and their general practitioner and others relevant health professionals. Also the development of the health care system and how to strengthen the health care system from their perspective will be a part of the interviews.     

Collaborating researchers and departments

Department of Regional Health Research - Focused Research Unit in Emergency Medicine, University of Southern Denmark and Department of Emergency, Hospital of Southern Jutland

• PhD student Lilian Keene Boye
• Associate professor, Head of research unit, Christian Backer Mogensen,

Department of Public Health – Research unit of Health Promotion, University of Southern Denmark

• Associate Professor, Head of Research Unit, Pernille Tanggaard Andersen

Department of Public Health – Research unit of General Practice, University of Southern Denmark 

• Professor, Deputy Head of Research Unit and General Practitioner, Frans Boch Waldorff

King Chr. Xth Hospital of Rheumatic Diseases, Research Unit of Rheumatology, Graasten   

Department of Public Health, Research Unit of User Perspectives, University of Southern Denmark

• Associate Professor Tine Mechlenborg Kristiansen