gms | German Medical Science

Background: Mobility limitations have a multitude of different negative consequences on the older adult including decreasing opportunities for social participation, increasing the risk for morbidity and premature death. However, current health care has several shortcomings regarding mobility limitations of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions, and deficiencies to personalize care based on patients’ needs, experiences and preferences. A comprehensive health care strategy targeted at mobility of older adults is still missing.

Objectives: To reduce the burden of disability in older adults, the evidence-based health care research network MobilE-Net therefore has the thematic objective to develop multi-professional care pathways targeted at mobility and social participation. Evidence-based health care (EBHC) strives to use best evidence when delivering health care and services. However, evidence is often not integrated into practice; for the complex problem of mobility, simplistic descriptive and narrative research approaches might be rejected because of their restricted relevance. To face these limitations and to implement EBHC research on a larger scale, MobilE-Net has the structural objective to provide the formal and methodological basis for an EBHC research cycle.

Methods/practical implications: MobilE-Net includes the following steps: We plan (1) to analyze current care practice and patient trajectories with objective instruments and tools, using two model health conditions as a case in point, (2) to formulate aims and frameworks of the investigated care options integrating the patients’ and providers’ perspectives, (3) to develop interventions and care pathways targeted at patients’ mobility and social participation, (4) to use appropriate, controlled designs to investigate cost and effectiveness of new care strategies across sectors, (5) to collaborate with all necessary local health care providers and stakeholders to bring new strategies into practice, and (6) eventually, to evaluate the consequences of the implementation in real life which may imply the need to rethink and optimize strategies, and to re-enter the cycle. While this proposal for an initial funding period of 3 years includes steps (1) to (5) (the developmental part of the cycle), step (6) (the confirmatory part of the cycle) builds on this collaboration experience and will be addressed at a later stage. The ultimate goal and vision is to reconsider and advance a more active and cooperative role of all health professions within the German health care system to realize the full potential of social participation in older adults. The network is based on the strong methodological expertise of the involved researchers from the fields of epidemiology, biostatistics, public health, general practice, specialized medicine, health economics, nursing science, physical therapy and movement science. To facilitate immediate clinical impact, translation and implementation, this network also comprises various clinical partners including primary care, acute and post-acute facilities, statutory health insurances, and health professionals’ organizations, and is endorsed by the Health Authorities. MobilE-Net will provide a multidisciplinary research, cooperation and communication platform with flat hierarchies and transparent decision making that offers attractive career opportunities for young researchers as well as a structured education program for health care research that can be entered at any stage of a professional or academic career.