A Brief Intervention to Improve Cost-effective Resource Use Among Medicine Housestaff

Not Applicable

Completed

• Conditions: Graduate Medical Education; Cost-Effectiveness
• Interventions: Behavioral: Educational Intervention

• Registration Number: NCT01303263
• Lead Sponsor: Brigham and Women's Hospital

Brief Summary

OBJECTIVE: To test a brief intervention designed to improve the cost-effectiveness of care provided by medicine housestaff for hospitalized patients.

HYPOTHESIS: A brief intervention in which medicine residents receive itemized bills for recent patients cared for by them, followed by a discussion on approaches to reducing unnecessary inpatient costs, can result in significant cost reductions without adversely affecting patient outcomes.

Detailed Description

We designed a brief educational intervention with two primary objectives: 1) to increase awareness among residents about how their decisions impact the costs of inpatient medical care; and 2) to improve the cost-effectiveness of care provided by residents without adversely affecting patient outcomes. We hypothesized that a brief intervention in which residents receive bills for patients they recently cared for, followed by a discussion on approaches to reducing unnecessary inpatient costs, would reduce costs without adversely affecting patient outcomes.

Study Timeline

• Study Start: 2009-09
• Primary Completion: 2010-12
• Status Verified: 2011-02
• Study Completion: 2011-02
• Study First Submitted: 2011-02-23
• Study First Submitted QC: 2011-02-23
• Study First Posted: 2011-02-24
• Last Update Submitted: 2011-06-21
• Last Update Posted: 2011-06-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 96

Inclusion Criteria

• Internal Medicine Residents on Inpatient Rotations at Brigham & Women's Hospital

Exclusion Criteria

• Having a team member who was in either the control group or intervention group in a prior round of this study.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Intervention Group	Educational Intervention	Residents Randomized to Receive Educational Intervention

Primary Outcome Measures

Name	Time	Method
Total Cost	2 weeks following educational intervention	Total hospital cost per admission for 2 weeks following the educational intervention.
Lab Cost	2 weeks following educational intervention	Total lab cost per admission for 2 weeks following the educational intervention.
Pharmacy Cost	2 weeks following educational intervention	Total pharmacy cost per admission for 2 weeks following the educational intervention.
Radiology Cost	2 weeks following educational intervention	Total radiology cost per admission for 2 weeks following the educational intervention.

Secondary Outcome Measures

Name	Time	Method
length of stay	2 weeks after educational intervention
admission to an intensive care unit (ICU)	2 weeks after educational intervention
30-day readmission	within 30 days after end of study period
30-day mortality	within 30 days after end of study period

Trial Locations

Locations (1)

Brigham & Women's Hospital; 🇺🇸 Boston, Massachusetts, United States