Collaborative Care for the Older Injured Patient: A Trauma Medical Home

Primary Specific Aim 1: Evaluate the ability of the TMH intervention to improve the physical recovery of the older injured patient.
Primary hypothesis: In comparison to the older injured patients randomized to usual care, those randomized to the TMH intervention will have the following at 6 and 12-month follow-ups:
• Higher physical performance as measured by the short physical performance battery (SPPB);
• Higher scores on the Physical Component Summary (PCS) of the Medical Outcomes Study 36-time short form (SF-36).
Secondary Specific Aim 2: Evaluate the ability of the TMH intervention to improve the psychological recovery of the older injured patient.
Secondary hypothesis 1: In comparison to older injured patients randomized to usual care, those who are randomized to the TMH intervention will have the following at 6 and 12-month follow-ups:
• Lower mood and anxiety symptoms as measured by the Patient Health Questionnaire–9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale;
• Higher scores on the Mental Component Summary (MCS) of the SF-36.

[Secondary Specific Aim 3: Evaluate the ability of the TMH intervention to reduce health cost and the TMH cost effectiveness relative to usual care of the non-neurologically injured patient.
Secondary hypothesis 2: In comparison to older injured patients randomized to usual care, those who are randomized to the TMH intervention will have the following at 6 and 12-month follow-ups:
• Fewer emergency department visits and hospital readmissions.
• Savings in healthcare utilization in the intervention arm will offset the intervention costs.]