Clinical trial NCT03293160: An Evaluation of the Michigan State Innovation Model in Washtenaw and Livingston Counties
Official title: An Evaluation of the Michigan State Innovation Model in Washtenaw and Livingston Counties
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: High Utilization of Emergency Departments
Lead sponsor: University of Michigan
Sponsor class: OTHER
Collaborators: name: Center for Healthcare Research and Transformation
name: Community Foundation of Southeast Michigan
First posted: 2017-09-26
Enrollment: 300
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: OTHER
Sampling method: PROBABILITY_SAMPLE
Study population: Patients who frequently use the emergency department of hospitals located in Washtenaw or Livingston Counties.

Brief summary: This study will examine the effects of a care management program on the health and health spending outcomes of patients residing in Michigan's Washtenaw and Livingston Counties.

Detailed description: In 2017, the State of Michigan will offer enrollment in care management services to a set of patients in Washtenaw and Livingston Counties who are predicted to be high-frequency users of emergency departments. This is a quality improvement initiative. The Center for Healthcare Research and Transformation (CHRT) will administer this enrollment and collect patient data. The Principal Investigators will conduct a study that uses the data from this quality improvement initiative to compare the outcomes of the treatment and control groups. Specifically, the study will examine whether the care management services had an effect on the number of emergency department visits and the total healthcare spending of the patients in the treatment group.

The present study therefore is the second of two related projects - the first is the CHRT-administered random assignment and enrollment of patients into care management services. The present study is a secondary analysis of the data produced by the first project.

This Protocol Registration and Results submission refers to the secondary analysis component wherever applicable, and where not applicable, describes the information relevant to the CHRT project. For example, while the present study does not assign anyone into treatment or control groups, the Sample Description indicates "Probability Sample" to describe the way in which CHRT intends to enroll patients.

Eligibility criteria: Inclusion criteria:

1. reside in Washtenaw or Livingston counties or have an unknown address;
2. Have a probability of being admitted to an emergency department (ED) in Washtenaw or Livingston counties that exceeds a threshold value in a predictive model;

Exclusion criteria

1. Patients referred by a community provider
2. Patient declines to consent

Primary outcomes:
measure: Emergency department utilization
timeFrame: 6 months
Secondary outcomes:
measure: Health care spending
timeFrame: 6 months
Other outcomes:
Locations:
city: Ann Arbor
country: United States
facility: Center for Healthcare Research & Transformation
state: Michigan
Study officials:
affiliation: Center for Healthcare Research & Transformation
name: Marianne Udow-Phillips, MHSA
role: STUDY_DIRECTOR
References:
citation: Post B, Lapedis J, Singh K, Valenstein P, Buyuktur AG, Teske K, Ryan AM. Predictive Model-Driven Hotspotting to Decrease Emergency Department Visits: a Randomized Controlled Trial. J Gen Intern Med. 2021 Sep;36(9):2563-2570. doi: 10.1007/s11606-021-06664-1. Epub 2021 Mar 10.