2008 Participants Needed

Comprehensive Care for Patients at High Risk of Hospitalization

(CCP Trial)

AC
GR
Overseen ByGregory Ruhnke, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Chicago
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Comprehensive Care for patients at high risk of hospitalization?

The research on reducing hospital-acquired infections, like pneumonia, shows that using a team approach and improving care processes can lead to better patient outcomes. This suggests that a comprehensive care approach, which likely includes similar strategies, could be effective in reducing hospitalizations.12345

Is Comprehensive Care for Patients at High Risk of Hospitalization safe?

The research articles provided focus on the safety of hospital care and adverse drug events, but do not specifically address the safety of Comprehensive Care for Patients at High Risk of Hospitalization. Therefore, there is no relevant safety information available for this specific treatment.678910

How is the Comprehensive Care treatment different from other treatments for patients at high risk of hospitalization?

The Comprehensive Care treatment is unique because it involves a physician model where doctors focus on both inpatient and outpatient care for patients at high risk of hospitalization, ensuring better care coordination and continuity. This approach contrasts with traditional care, where different doctors handle hospital and outpatient care separately, often leading to communication issues and increased costs.1112131415

What is the purpose of this trial?

The investigators propose an innovative new model of care in which patients identified to be at high risk of hospitalization are offered care by a physician who will direct their care both in the hospital and in clinic but is able to do so because they see patients only at high risk of hospitalization. This allows these physicians to have a panel of patients that is small enough that they can provide them with continuing ambulatory care but sick enough for those physicians to have enough of their patients hospitalized at any time to justify having the physician spend several hours each morning seeing those patients in the hospital, making the model economically viable and clinically valuable for the patient. The investigators estimate that each of the 5 physicians the investigators propose to establish in this model will serve a panel of about 200 patients in steady state with an average of 10 days of expected hospitalization and $75,000 each in Medicare spending per year, totaling $75 million annually. The investigators estimate that a 1% reduction in costs for these patients will be more than enough to cover the ongoing costs of the model the investigators propose; this is because the investigators' program reorganizes care rather than adding new forms of care.

Research Team

DM

David Meltzer, MD, PhD

Principal Investigator

University of Chicago

Eligibility Criteria

This trial is for Medicare recipients who have been hospitalized at least once in the past year and are considered high risk for future hospitalizations. The goal is to provide these patients with a dedicated physician who manages their care both during hospital stays and outpatient clinic visits.

Inclusion Criteria

I am on Medicare and was hospitalized at least once last year.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive care from a Comprehensive Care Physician both in outpatient clinics and during hospitalizations

Up to 3 years
Regular visits as needed based on patient condition

Follow-up

Participants are monitored for health outcomes, care utilization, and patient satisfaction

Up to 3 years
Quarterly assessments

Treatment Details

Interventions

  • Comprehensive Care
Trial Overview The trial tests a new care model where high-risk patients receive integrated inpatient and outpatient services from the same physician, aiming to reduce hospitalizations and costs. Five physicians will each manage about 200 patients, focusing on continuity of care.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Comprehensive CareExperimental Treatment1 Intervention
Patients randomized to the Comprehensive Care group are assigned to a Comprehensive Care physician and are asked to see their assigned CCP for their primary care. The patients will receive their care by the CCP in the outpatient clinic and also if they were to be hospitalized.
Group II: Standard of CareActive Control1 Intervention
If patients are randomized to standard of care, they are not assigned to a Comprehensive Care Physician. They are asked to continue receiving their care as they normally would.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Chicago

Lead Sponsor

Trials
1,086
Recruited
844,000+

Endeavor Health

Collaborator

Trials
135
Recruited
742,000+

University HealthSystem Consortium

Collaborator

Trials
2
Recruited
2,000+

University of Illinois at Chicago

Collaborator

Trials
653
Recruited
1,574,000+

Rush University Medical Center

Collaborator

Trials
448
Recruited
247,000+

Northwestern University

Collaborator

Trials
1,674
Recruited
989,000+

NorthShore University HealthSystem

Collaborator

Trials
134
Recruited
740,000+

Findings from Research

Patient outcomes research can enhance the quality of care by improving how healthcare is delivered, focusing on both structures and processes.
Collaboration among different healthcare disciplines is essential for effectively analyzing outcomes, which can help identify cost-effective practices that lead to better patient results.
Outcomes analysis: methods and issues.Jones, KR.[2019]
In a study of 182 patients aged 20-69 with femoral neck fractures treated with internal fixation, 73% of those with displaced fractures and 85% with non-displaced fractures reported good or excellent functional outcomes at 24 months.
Despite a significant percentage achieving good functional outcomes, patients did not fully regain their pre-fracture health-related quality of life, indicating that while surgical intervention is effective, it may not restore overall quality of life.
Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients.Campenfeldt, P., Hedström, M., Ekström, W., et al.[2018]
In a study of 2809 hospital admissions, 23.6% experienced at least one adverse event, highlighting a significant issue in patient safety during hospitalization.
Of the identified adverse events, 22.7% were deemed preventable, indicating that improvements in hospital practices could reduce patient harm, particularly from adverse drug events, which were the most common type.
The Safety of Inpatient Health Care.Bates, DW., Levine, DM., Salmasian, H., et al.[2023]

References

Outcomes analysis: methods and issues. [2019]
Reducing the incidence of nosocomial pneumonia in cardiovascular surgery patients. [2019]
Validation of the short form-36 health survey supported with isokinetic strength testing after sport knee injury. [2022]
The relation between health status changes and patient satisfaction in older hospitalized medical patients. [2022]
Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients. [2018]
Detection of drug-related adverse events in hospitals. [2019]
The Safety of Inpatient Health Care. [2023]
An alternative strategy for studying adverse events in medical care. [2022]
A multicenter record review of in-hospital adverse drug events requiring a higher level of care. [2018]
[Costs of serious adverse events in a community teaching hospital, in Mexico]. [2018]
11.United Statespubmed.ncbi.nlm.nih.gov
Using Palliative Care Nurses in a Supportive Care Program to Reduce Hospital Utilization for Patients With Multiple Chronic Conditions. [2023]
Primary care practice-based care management for chronically ill patients (PraCMan): study protocol for a cluster randomized controlled trial [ISRCTN56104508]. [2023]
13.United Statespubmed.ncbi.nlm.nih.gov
Redesigning care for patients at increased hospitalization risk: the Comprehensive Care Physician model. [2021]
Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review. [2022]
The Comprehensive Care Plan: A Patient-Centered, Multidisciplinary Communication Tool for Frequently Hospitalized Patients. [2021]
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