Clinical trial NCT05807750: Effects Of Income Supplements On 30-Day Readmissions For Vulnerable Older Adults
Official title: Effects Of Income Supplements On 30-Day Readmissions For Vulnerable Older Adults: A Randomized, Controlled, 300-Subject Clinical Trial
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Patient Readmission
Keywords: Patient Readmission
Income
Lead sponsor: AltaMed Health Services Corporation
Sponsor class: OTHER
Collaborators: name: National Institute on Aging (NIA)
name: University of Southern California
First posted: 2023-04-11
Enrollment: 8
Sex: ALL
Minimum age (years): 55
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief 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.


Eligibility criteria: 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

Primary outcomes:
measure: Unplanned 30-day readmission
timeFrame: Within 30 days of the index hospital discharge
Secondary outcomes:
measure: 30-day post-discharge medical expenditures
timeFrame: Within 30 days of the index hospital discharge
measure: 90-day post-discharge medical expenditures
timeFrame: Within 90 days of the index hospital discharge
measure: 30-day post-discharge medical readmission OR emergency department visit
timeFrame: Within 30 days of the index hospital discharge
measure: 90-day post-discharge medical readmission OR emergency department visit
timeFrame: Within 90 days of the index hospital discharge
measure: Unplanned 90-day readmission
timeFrame: Within 90 days of the index hospital discharge
Other outcomes:
measure: Post-discharge care plan adherence
timeFrame: Within 90 days of the index hospital discharge
Locations:
city: Los Angeles
country: United States
facility: AltaMed Health Services Corporation
state: California
Study officials:
affiliation: Brandeis University
name: Rajan A Sonik, PhD, JD, MPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.