Practical Alternative to Hospitalization
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 72
- 试验地点
- 1
- 主要终点
- Days at home over 30 days
研究概览
简要总结
The investigators test the PATH program to evaluate whether the program allows patients to spend more days at home in comparison to patients who receive regular care. The program will involve patients from Penn Presbyterian Medical Center with a set of diagnoses and will provide patients with enhanced services upon discharge from the emergency department.
详细描述
The PATH program seeks to provide patients with enhanced services upon discharge from the emergency department, including visiting home nurses, visiting home physical and occupational therapists, scheduled frequent telephone visits with a medical provider, care coordination to arrange outpatient evaluation and testing, social work services, and other services. The purpose of this study is to evaluate whether the PATH program allows patients to spend more days at home in comparison to patients who receive regular care.
The broad goal of this program is to provide patients with a personalized package of enhanced services following discharge from the emergency department. In some cases, patients enrolled in the PATH program are likely to be discharged home regardless of enrollment, but are deemed potentially high-risk for returning to the hospital due to their illness or other factors. In other cases, enrolled patients might otherwise have been hospitalized but decide with their clinician that recovery at home is possible with the increased supervision and care provided by PATH. For all patients, we seek to determine whether PATH is effective in expediting patient recovery from acute illness and reduce the time spent in hospital or nursing facilities.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Stable (Patients are deemed stable by ED clinician and PATH clinician per review of vital signs, history, exam, test results, and functional status)
- •Have active insurance
- •Domiciled at home (Patients must live in the community and not in nursing facility, shelter, or otherwise homeless)
- •Safe home environment
- •Live in Penn Medicine Home Health (PMHH) geographic catchment if enrolled in PMHH services
排除标准
- •Substance use disorder (No active untreated SUD, including alcohol, opioids, cocaine, or stimulants)
- •Serious mental health condition
- •Police custody
- •Homelessness
- •Anticipated procedures or surgeries
- •IV access (Patients with need for home infusion services or frequent blood testing after discharge must have standard level of IV access)
研究组 & 干预措施
PATH Intervention
Patients in the treatment arm will receive a personalized plan of care upon discharge from the emergency department.
干预措施: PATH Intervention (Other)
Routine Care
Patients in the control arm will receive standard-of-care services (the care plan that the emergency physician would normally offer if PATH were not available) without PATH enrollment.
结局指标
主要结局
Days at home over 30 days
时间窗: 30 days
The number 30 minus the amount of days that patients spend in a hospital, nursing facility, or ED after discharge from the initial ED visit
Days that patients are expired
时间窗: 30 days
The number of days that patients are expired
次要结局
- Impact of PATH on hospital operations - percentage of hospitalized patients(5 months)
- Impact of PATH on hospital operations - Capture rate(5 months)
- Quality of life at 30 days(5 months)
- Functional status at 30 days(5 months)
- Estimated cost (allowed charges) based on healthcare utilization(5 months)
