Effects Of Income Supplements On 30-Day Readmissions For Vulnerable Older Adults

Patient Readmission Clinical Trial

Official title:

Effects Of Income Supplements On 30-Day Readmissions For Vulnerable Older Adults: A Randomized, Controlled, 300-Subject Clinical Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05807750
• Other study ID #: 2023-001 Sonik Readmit RCT
• Secondary ID: P30AG024968
• Status: Recruiting
• Phase: N/A
• Start date: June 21, 2023
• Est. completion date: February 28, 2025

Study information

• Verified date: March 2024
• Source: AltaMed Health Services Corporation
• Contact: Rajan A Sonik, PhD, JD, MPH
• Phone: 323-765-6672
• Email: rsonik[@]altamed.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Unplanned 30-day hospital readmissions are an critical healthcare quality metric, with meaningful effects on patients and health systems operations. Interventions to reduce unplanned readmissions have primarily operated within a healthcare-centric frame, with enhancements to either pre- or post-discharge care planning, medication reconciliation, or visit frequency. Associations of 30-day readmission rates with poverty status and other social factors, however, suggest that attending to unmet social needs may yield added benefits to models focused on healthcare delivery. The purpose of the present trial is to provide evidence regarding the effects on 30-day readmissions of providing a one-time post-discharge income supplement to socially vulnerable older adults with medical complexity participating in an enhanced care coordination program.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 300
• Est. completion date: February 28, 2025
• Est. primary completion date: February 28, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 55 Years and older

Eligibility

Inclusion Criteria:

• A participant in the underlying enhanced care planning program
• aged 55 years or older
• attending an outpatient clinic appointment as part of the underlying enhanced care planning program within 10 days of being discharged from an inpatient hospital stay
• able to understand the study consent form (with interpretation services if needed)

Exclusion Criteria:

• The candidate is not discharged from the index admission to a community setting (e.g., they will be excluded if they are discharged to a skilled nursing facility)
• The candidate has a legal guardian with control over financial decision-making
• The candidate has been approached about the study during a previous encounter
• The index hospitalization was a planned admission

Related Conditions & MeSH terms

• Patient Readmission

Intervention

Other:
• Post-discharge income supplement
$300 income supplement
• Enhanced care planning
Enhanced care planning provided by a nurse care manager

Locations

Country	Name	City	State
United States	AltaMed Health Services Corporation	Los Angeles	California

Sponsors (3)

Lead Sponsor	Collaborator
AltaMed Health Services Corporation	National Institute on Aging (NIA), University of Southern California

Country where clinical trial is conducted

United States, 

References & Publications (1)

Calvillo-King L, Arnold D, Eubank KJ, Lo M, Yunyongying P, Stieglitz H, Halm EA. Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: systematic review. J Gen Intern Med. 2013 Feb;28(2):269-82. doi: 10.1007/s11606-012-2235-x. Epub 2012 Oct 6. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Post-discharge care plan adherence	Clinic visit attendance, medication fills/refills	Within 90 days of the index hospital discharge
Primary	Unplanned 30-day readmission	Whether a participant has an unplanned readmission within 30 days of the index hospital discharge	Within 30 days of the index hospital discharge
Secondary	30-day post-discharge medical expenditures	Total medical expenditures in the 30 days after the index hospital discharge	Within 30 days of the index hospital discharge
Secondary	90-day post-discharge medical expenditures	Total medical expenditures in the 90 days after the index hospital discharge	Within 90 days of the index hospital discharge
Secondary	30-day post-discharge medical readmission OR emergency department visit	Whether a participant has an unplanned readmission OR emergency department visit within 30 days of the index hospital discharge	Within 30 days of the index hospital discharge
Secondary	90-day post-discharge medical readmission OR emergency department visit	Whether a participant has an unplanned readmission OR emergency department visit within 90 days of the index hospital discharge	Within 90 days of the index hospital discharge
Secondary	Unplanned 90-day readmission	Whether a participant has an unplanned readmission within 90 days of the index hospital discharge	Within 90 days of the index hospital discharge