SHM Converge Scientific Abstract ePoster Gallery-Effects of a Comprehensive Care Physician Program on Hospitalization Rates

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A randomized clinical trial evaluated UChicago Medicine’s Comprehensive Care Physician (CCP) model for Medicare patients at high risk of hospitalization. The CCP model assigns patients the same physician for both inpatient and outpatient care, aiming to reduce fragmented care and improve outcomes compared with standard care, where different doctors manage care in and out of the hospital.<br /><br />The study included 2,000 Medicare patients in a longitudinal randomized controlled trial. Hospitalization rates were analyzed using negative binomial models adjusted for baseline characteristics including age, sex, dual eligibility, general health, and functional status.<br /><br />Overall, patients assigned to CCP had a significantly lower hospitalization rate than those receiving standard care. In the full sample of 1,916 patients with available data, hospitalization was reduced by about 14% (IRR 0.86, p=0.047). Effects were stronger in certain groups: patients age 65 had a 21% lower hospitalization rate, patients with one prior hospitalization in the previous year had a 17% lower rate, and non-dual-eligible patients had a 28% lower rate. Among the 87% of patients with at least one of these favorable characteristics, hospitalization fell by 19%. In contrast, the small subgroup of patients who were younger, dual eligible, and had no prior hospitalizations showed a nonsignificant trend toward higher hospitalization with CCP.<br /><br />The authors conclude that the CCP program can significantly reduce hospitalizations among Medicare patients, especially those age 65, non-dual, or with a recent hospitalization history. They suggest further implementation and evaluation of the model, particularly in value-based care settings, and note that additional social-support interventions may be needed for younger and dual-eligible patients.

Asset Subtitle

David O. Meltzer

Meta Tag

Author List Andrea P. Flores, Andrew W. Schram, David O. Meltzer, Emily Perish, Grace LaShore, Greg Ruhnke, Hui Zhang, James Zhang, John Cursio, Joyce Tang, Ram Krishnamoorthi, Robert Gibbons

Category Research

Concept Comprehensive Care Physician model

Concept Hospitalization Outcome

Concept Randomized Controlled Trial

Concept Hospitalization Risk

Concept Standard care

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author David O. Meltzer

Track Outcomes Research

Keywords

randomized clinical trial

Comprehensive Care Physician model

Medicare patients

hospitalization reduction

inpatient outpatient continuity

standard care comparison

negative binomial models

value-based care

dual eligible

longitudinal randomized controlled trial

Comprehensive Care Physician model

Hospitalization Outcome

Randomized Controlled Trial

Hospitalization Risk

Standard care