Post-Acute Physician Home Visit Program

Not Applicable

Completed

• Conditions: A Patient Discharged From an Acute-care Hospital Who Had an Acute Illness

• Registration Number: NCT03178513
• Lead Sponsor: Brigham and Women's Hospital

Brief Summary

New or worsening symptoms following discharge from the hospital likely leads to unplanned readmission. These rates are higher than desired and costly to patients, payers, and providers. Many interventions have unsuccessfully attempted to reduce readmissions, but few have provided in-home personnel to patients transitioning from acute care back to ambulatory care. Still fewer have involved a physician in the home. We therefore will test the effect of a physician home visit to a patient's home who was discharged in the last 4 days.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2017-06-05
• Study First Submitted QC: 2017-06-05
• Study Start: 2017-06-06
• Study First Posted: 2017-06-07
• Primary Completion: 2018-01-20
• Study Completion: 2018-01-20
• Status Verified: 2019-08
• Last Update Submitted: 2019-08-09
• Last Update Posted: 2019-08-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 51

Inclusion Criteria

• Resides within either a 5-mile or 20-minute driving radius of Brigham and Women's Hospital (BWH) or Brigham and Women's Faulkner Hospital (BWFH) emergency room
• Has capacity to consent to study
• >=18 years old

Exclusion Criteria

• Undomiciled
• In police custody
• Domestic violence screen positive

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
New or worsening symptoms	30 days after discharge from hospital	"Since you got home from the hospital, have you had any symptoms at all?" If no, stop. If yes, continue.; "I'm going to read off a list of symptoms, and I want you to tell me if that symptom is new or has gotten worse since you left the hospital. Please don't include symptoms that have stayed the same since you were in the hospital." For each affirmative, double check if the symptom is new or has gotten worse since getting out of the hospital. Only if new or worse, mark yes.

Secondary Outcome Measures

Name	Time	Method
Receipt of prescribed medicines following discharge, y/n	30 days after discharge	Pharmacy confirmation
Primary care provider follow-up within 14 days, y/n	Day of discharge to 14 days later
Total reimbursement, 30-days post discharge	Day of discharge to 30 days later
Total cost, 30-days post discharge	Day of discharge to 30 days later
Ability to carry out the discharge plan, score	30 days after discharge	I would like to ask you about some more problems that you might have faced after you left the hospital one month ago. I will read some statements and ask if you agree or disagree.
3-item Care Transition Measure, score	30 days after discharge
Change in medication list due to home visit, y/n	Day of home visit	Physician-initiated medication change during home visit
Unplanned 30-day readmission(s) after index hospitalization, #	30 days after discharge
Unplanned 30-day readmission(s) after index hospitalization, y/n	30 days after discharge

Trial Locations

Locations (2)

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

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