| Field | Before | After |
|---|---|---|
| Field Trial Status | Before in_development | After completed |
| Field Abstract | Before This randomized trial investigates the impact of the Camden Coalition of Healthcare Providers' Care Management Program: Link2Care. The program targets "super-utilizers" of the health care system - specifically adults with 2 or more hospitalizations in the last six months and 2 or more chronic conditions - with intensive care-management services in the one to three months following hospital discharge. A team of nurses, social workers, community health workers and health coaches, supported by real-time data of healthcare utilization, perform home visits, accompany patients to doctor visits, and help patients enroll in social-service programs. This approach aims to improve the self-sufficiency of patients in navigating the healthcare and social- service systems and has the potential to reduce healthcare costs and improve patient health. Through random assignment to the intervention, we plan to study the impact of the Link2Care program, particularly on subsequent hospital use. | After This randomized trial investigates the impact of the Camden Coalition of Healthcare Providers' Care Management Program: Link2Care. The program targets "super-utilizers" of the health care system - specifically adults with 2 or more hospitalizations in the last six months and 2 or more chronic conditions - with intensive care-management services in the one to three months following hospital discharge. A team of nurses, social workers, community health workers and health coaches, supported by real-time data of healthcare utilization, perform home visits, accompany patients to doctor visits, and help patients enroll in social-service programs. This approach aims to improve the self-sufficiency of patients in navigating the healthcare and social- service systems and has the potential to reduce healthcare costs and improve patient health. We randomly assigned 800 hospitalized patients with medically and socially complex conditions, all with at least one additional hospitalization in the preceding 6 months, to the Coalition’s care-transition program or to usual care. The primary outcome was hospital readmission within 180 days after discharge. In this randomized, controlled trial involving patients with very high use of health care services, readmission rates were not lower among patients randomly assigned to the Coalition’s program than among those who received usual care. The 180-day readmission rate was 62.3% in the intervention group and 61.7% in the control group. The adjusted between-group difference was not significant (0.82 percentage points; 95% confidence interval, −5.97 to 7.61). In contrast, a comparison of the intervention-group admissions during the 6 months before and after enrollment misleadingly suggested a 38-percentage-point decline in admissions related to the intervention because the comparison did not account for the similar decline in the control group. |
| Field Trial End Date | Before July 01, 2020 | After January 07, 2020 |
| Field Last Published | Before June 17, 2017 10:31 AM | After January 08, 2020 05:03 PM |
| Field Study Withdrawn | Before | After No |
| Field Intervention Completion Date | Before | After October 01, 2017 |
| Field Data Collection Complete | Before | After No |
| Field Is there a restricted access data set available on request? | Before | After No |
| Field Program Files | Before | After Yes |
| Field Program Files URL | Before | After https://doi.org/10.7910/DVN/ZJVVQZ |
| Field Is data available for public use? | Before | After No |
| Field Pi as first author | Before No | After Yes |
| Field | Before | After |
|---|---|---|
| Field Paper Abstract | Before | After BACKGROUND There is widespread interest in programs aiming to reduce spending and improve health care quality among “superutilizers,” patients with very high use of health care services. The “hotspotting” program created by the Camden Coalition of Healthcare Providers (hereafter, the Coalition) has received national attention as a promising superutilizer intervention and has been expanded to cities around the country. In the months after hospital discharge, a team of nurses, social workers, and community health workers visits enrolled patients to coordinate outpatient care and link them with social services. METHODS We randomly assigned 800 hospitalized patients with medically and socially complex conditions, all with at least one additional hospitalization in the preceding 6 months, to the Coalition’s care-transition program or to usual care. The primary outcome was hospital readmission within 180 days after discharge. RESULTS The 180-day readmission rate was 62.3% in the intervention group and 61.7% in the control group. The adjusted between-group difference was not significant (0.82 percentage points; 95% confidence interval, −5.97 to 7.61). In contrast, a comparison of the intervention-group admissions during the 6 months before and after enrollment misleadingly suggested a 38-percentage-point decline in admissions related to the intervention because the comparison did not account for the similar decline in the control group. CONCLUSIONS In this randomized, controlled trial involving patients with very high use of health care services, readmission rates were not lower among patients randomly assigned to the Coalition’s program than among those who received usual care. (Funded by the National Institute on Aging and others; ClinicalTrials.gov number, NCT02090426; American Economic Association registry number, AEARCTR-0000329.) |
| Field Paper Citation | Before | After Finkelstein, Amy, Annetta Zhou, Sarah Taubman, and Joseph Doyle. 2020. “Health Care Hotspotting – A Randomized, Controlled Trial.” The New England Journal of Medicine 382, no. 2 (January 9): 152-62. https://www.nejm.org/doi/full/10.1056/NEJMsa1906848. |
| Field Paper URL | Before | After https://www.nejm.org/doi/full/10.1056/NEJMsa1906848 |
| Field | Value |
|---|---|
| Field Affiliation | Value Department of Family Medicine, Cooper Health System |