Emergency Department Utilization Clinical Trial
Official title:
The Impact of Patient Complexity on Healthcare Utilization
Healthcare providers are routinely being assessed for metrics designed to assess the quality of the care they deliver. There is growing consensus that these measurements, which typically assess the percentage of patients meeting a specific standard of care, should be adjusted for the clinical complexity of the providers. This study will assess whether adjusting for the social complexity of the patient panel adds significantly to adjustment for clinical complexity in explaining apparent differences in quality of care provided by Primary care providers and clinics.
The analysis will be conducted in 2 stages. In the first stage, indicators of social
complexity (as assessed by characteristics of the patients' geocoded addresses) will be
tested for significant association with patient level outcomes (meeting or not meeting a
specific standard of care). These indicators will be assessed in 4 cohorts: 2 cohorts of
patients identified in electronic health records of Clinical Research Networks of community
health centers, and 2 cohorts of patients insured by Medicaid in 2015 (Oregon and Florida
Medicaid cohorts). Due to limitations in the available data, some quality indicators can only
be evaluated in a subset of the cohorts. The consistency of specific social complexity
indicators, referred to as Community Vital Signs (CVS), will be evaluated across the cohorts
and quality metrics.
In the second stage, CVS indicators that contributed consistently to models at the patient
level will be evaluated for their effect on provider ranking on quality metrics if the
metrics are adjusted for the social complexity of the providers' patient panel in addition to
the panels' clinical complexity.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT01543438 -
Using Point-of-Care Video Prescriptions to Improve Aftercare Following Discharge From a Pediatric Emergency Department
|
N/A |