Evaluating the Impact of a Supportive Care Program

NYU Langone Health

Status: Completed

Conditions: Morality; Patient Engagement

Treatments: Behavioral: Supportive care program

Study type: Observational

Funder types: Other

Identifiers

NCT04971278

QI-High Risk

Details and patient eligibility

About

NYU's High Risk Program targets patients who may be more likely to have increased hospitalization due to health conditions that may cause death in the near future. Community Health Workers, a home visiting doctor service, a supportive care nurse, and behavioral health specialist engage the population to address a range of biopsychosocial needs with end goal in increasing support in the community and engaging palliative and hospice care when appropriate to prevent hospital readmissions, shorten length of stay, reduce hospital utilization, and decrease overall patient cost with a focus on hospital spend.

Enrollment: 1,201 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years or older
• at or above the 75th percentile on the Mortality Model
• Attributed to a value based contract

Exclusion criteria

• Less than 18 years of age
• Below the 75th percentile on the Mortality Model
• Not attributed to a value based contract

Trial design

1,201 participants in 4 patient groups

HealthFirst Intervention

Description:

Patients attributed to HealthFirst who will receive the intervention

Treatment:

Behavioral: Supportive care program

HealthFirst Control

Description:

Patients attributed to HealthFirst who will not receive the intervention

Mortality Model Intervention

Description:

Patients who are identified as High Risk by the mortality predictive model and who receive the intervention.

Treatment:

Behavioral: Supportive care program

Mortality Model Control

Description:

Patients who are identified as High Risk by the mortality predictive model and who do not receive the intervention.