Older adults | Instrument | Baseline | 6 Months | 12 Months | 18 Months | 24 Months | |
---|---|---|---|---|---|---|---|
Patient outcomes | 1. Quality of Life | SF-12 [26] | x | x | x | x | x |
2. Health-related Quality of Life | EuroQol (EQ-5D) [27] | x | x | x | x | x | |
3. Independence in ADL | Katz ADL index [28] | x | x | x | x | x | |
4. Psychological Wellbeing | RAND-36 subscale [29] | x | x | x | x | x | |
5. Social Functioning | 1 item on RAND-36 scale | x | x | x | x | x | |
6. Self-reported Health | 2 items on RAND-36 scale | x | x | x | x | x | |
7. Acute Hospital Admissions | 1 item of our data set and Cost Dairies | x | x | x | x | x | |
Quality of Care | 8. Care Needs | CANE [30] | x | x | x | ||
Process Outcomes: Achieved transition | 9. Patient-reported Client-centred Care | CCCQ [31] | x | x | x | x | x |
10. Coordination of Care from the patient’s perspective | 2 items on QUOTE [32] | x | x | x | x | x | |
Informal Caregivers | Instrument | Baseline | 6 Months | 12 Months | 18 Months | 24 Months | |
Carer outcomes | 12. Quality of life | SF-12 | x | x | x | x | x |
13. Self-rated Burden of Care | CarerQol [33] | x | x | x | x | x | |
Older adults and informal caregivers | Instrument | Baseline | 6 Months | 12 Months | 18 Months | 24 Months | |
Costs | Direct and Indirect Costs | Cost diaries |