Trial to Reduce Hospitalizations in Children With Medical Complexity

Study Overview
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Brief Summary
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The investigators hypothesize that an intervention, within an established patient-centered medical home, aimed at reducing modifiable risks for hospitalization, can decrease hospital utilization among medically complex children.

Detailed Description
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The investigators will pilot test an intervention that includes contingency planning and care transitions within an established medical home program caring for children with medical complexity. Children with medical complexity receiving care within the UCLA Medical Home Program will be randomized to the pilot intervention or usual medical home care. The primary goal will be to reduce admissions and readmissions in the intervention group.

Official Title
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Randomized Controlled Trial to Decrease Admission Rates in Medically Complex Children in a Medical Home Program

Conditions
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Chronic Illness

Intervention / Treatment
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* Behavioral: Plans of Action and Care Transitions
* Behavioral: Routine Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children ages 0 to 17 years old who are enrolled in the Pediatric Medical Home Program at UCLA English and Spanish-speaking only Exclusion Criteria: Children older than 17 years old who are enrolled in the Pediatric Medical Home Program Non-English and Non-Spanish speakers

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Subjects randomized to the intervention group will participate in a bundled intervention that includes action planning and care transitions (for those hospitalized during the study period) | Behavioral: Plans of Action and Care Transitions<br>* Subjects randomized to the intervention will participate in action planning and care transitions (if hospitalized during the study period)<br>|
| Placebo Comparator: Routine Care<br>Subjects randomized to the routine care group will continue to receive their usual care from the Pediatric Medical Home Program at UCLA | Behavioral: Routine Care<br>* Subjects randomized to the control group will continue to receive routine care within the medical home program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| (1) number of all-cause admissions, defined as any admission occurring during the study period |  | 18 to 24 months | 
| (2) preventable admissions, defined by 2 independent physicians blinded to study assignment as an admission due primarily to one of the preventable factors identified from Phase 1 of the study |  | 18 to 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hospitalization, Readmissions, Medical complexity