Standard Care Coordination Expansion Pilot - A Quality Improvement Study
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 发起方
- 入组人数
- 592,023
- 试验地点
- 2
- 主要终点
- Total Cost
研究概览
简要总结
The Standard Care Coordination (SCC) solution integrates aspects of case management & care coordination & was designed by UnitedHealth Group for high-cost, complex, at-risk consumers to facilitate health care access and decisions that can have a dramatic impact on the quality and affordability of the consumer's health care. Currently members only receive the SCC if they are: 1) identified as high risk for readmission upon discharge from the hospital, 2) are self-referred, or 3) are directly referred to the program by their physician. The current quality improvement study was designed as a randomized controlled trial to determine if the expansion of the SCC program to commercially insured members identified via a proprietary administrative algorithms as being at high risk would significantly impact rates of acute inpatient admissions.
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
- None
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
- •UnitedHealthcare commercial Fully Insured members; all states; 18+ years old; actively enrolled in the health plan as of randomization identified via proprietary administrative algorithm as being at high risk for persistent super utilizer status.
排除标准
- •: pregnant women, individuals prescribed medications for infertility, members with evidence of dementing disorders, members indicated as "do not contact " for program outreach, and Members in the following products and plans:
- •legacy UHC ASO groups (populations for which UHC provides administrative services only),
- •legacy Oxford health plan members (all members receive the SCC program),
- •legacy PacifiCare members,
- •legacy River Valley/NHP members, and
- •Public Sector clients
- •the PHS 2.0 intervention (a small population within Fully Insured)
- •assignment to a clinically activated Accountable Care Organization (ACO)
结局指标
主要结局
Total Cost
时间窗: 24 months
Defined as total plan cost (medical and pharmacy) per member
Emergency Room Visit Rate
时间窗: 24 months
Defined as the number of emergency room visits per 1,000 qualified members
Acute Inpatient Admission Rate
时间窗: 24 months
Defined as acute inpatient admissions per 1,000 qualified members
Diabetes-Related Complications
时间窗: 24 months
Defined as the Diabetes Complications Severity Index (DCSI) composite score. The composite DCSI score ranges between 0 to 13 (sum of scores from 7 diabetes complication categories \[cardiovascular disease, cerebrovascular disease/stroke, peripheral vascular disease, nephropathy, retinopathy, neuropathy, and metabolic complications such as ketoacidosis, hyperosmolar, or other coma\] which are each scored from 0 to 2 \[0=no complication, 1=non-severe complication, 2=severe complication\], except for neuropathy which is scored from 0 to 1)
次要结局
- Outpatient Emergency Room Visit Rate(12, 18, 24, 36, 48 months)
- Specialist Physician Visit Rate(12, 18, 24, 36, 48 months)
- Nephropathy(12, 18, 24, 36, 48 months)
- Retinopathy(12, 18, 24, 36, 48 months)
- Neuropathy(12, 18, 24, 36, 48 months)
- Risk of Acute Inpatient Admission(12, 18, 24, 36, 48 months)
- Risk of Emergency Room Visit(12, 18, 24, 36, 48 months)
- Cardiovascular Disease(12, 18, 24, 36, 48 months)
- Diabetes-related complications (DCSI)(12, 18, 24, 36, 48 months)
- Adherence to Diabetes-Related Processes of Care(12, 18, 24, 36, 48 months)
- Total Plan and Member Cost(12, 18, 24, 36, 48 months)
- Any Acute Inpatient Admission(12, 18, 24, 36, 48 months)
- Metabolic complications such as ketoacidosis, hyperosmolar, or other coma(12, 18, 24, 36, 48 months)
- Amputations(12, 18, 24, 36, 48 months)
- Glycemic Control(12, 18, 24, 36, 48 months)
- Any Emergency Room Visit(12, 18, 24, 36, 48 months)
- Cerebrovascular disease/stroke(12, 18, 24, 36, 48 months)
- All-Cause 30-Day Readmission Risk(12, 18, 24, 36, 48 months)
- Primary Care Physician Visit Rate(12, 18, 24, 36, 48 months)
- Chronic Kidney Disease(12, 18, 24, 36, 48 months)
- Adherence to Diabetes-Related Medications(12, 18, 24, 36, 48 months)
- Peripheral vascular disease(12, 18, 24, 36, 48 months)
- Diabetes Complications Count(12, 18, 24, 36, 48 months)
研究者
Anthony Pirrello
Director UHC E&I Healthcare Econ
UnitedHealthcare