IMPACCT for Kids' Care

OCHIN

Status: Completed

Conditions: Insurance Status/Stability

Treatments: Other: Health insurance outreach IT tools

Study type: Observational

Funder types: Other

Identifiers

NCT02298361

PCORI Award (308)

Details and patient eligibility

About

Health insurance is important for children. Public insurance programs are available to many children, but some families report being confused about how to get and keep this insurance. Community Health Centers (CHCs) can help families get and keep health insurance for their children.

The investigators will work with families, policy makers, and community health care providers and staff to develop and test new computer health information technology (IT) tools to help health care clinics find pediatric patients in need of insurance and communicate with their families about public insurance programs. These tools will be based on technologies currently used to help patients and clinics manage chronic diseases. The investigators will test the tools by comparing four clinics using the tools and four clinics not using the tools. The investigators will look to see if children in the clinics using the tools are more likely to have health insurance and also more likely to receive certain health care services, compared to children in the clinics without such tools. The investigators will also look at health insurance rates and health care services for a larger population of Oregon children.

Full description

Summary of protocol changes made:

1. Changes to eligibility criteria. We changed patient eligibility to include all pediatric patients through age 19 with >=1 clinical visit in the study period. These decisions were based on: 1) at age 20, individuals are no longer eligible for children's Medicaid or CHIP in Oregon; 2) identification of PCP assignment was difficult in the EHR.
2. Added second comparison group/study arm. In the intervention clinics, the tools were used on a smaller number of pediatric patients than anticipated, and there were significant demographic differences between intervention and control site patients, despite the clinics being matched. Thus we added a second comparison group, "within-clinic comparison patients" as pediatric patients with >=1 visit at an intervention clinic in the study period but on whom the tools were NOT used. This provided a comparison group that accounted for clinic-level effects and was more demographically similar to the "intervention patients" on whom tools were used.
3. Revision of Aim 3 - CHIPRA recommended care assessment. We did not pursue assessment of CHIPRA quality care measures due to 1) limited follow-up time due to the need to implement iterative modifications to the study HIT tools, and 2) the tools were used on a smaller set of pediatric patients than anticipated, thus we had a very limited denominator for these analyses.

Enrollment: 27,251 patients

Sex: All

Ages: Under 19 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• age 0-19
• established patient (>=1 clinical visit at a study clinic in the assessment period)

Exclusion criteria

• age > 19
• not an established patient

Trial design

27,251 participants in 3 patient groups

Intervention patients

Description:

Community Health Centers that implemented health insurance outreach IT tools: active patients on whom tools were used

Treatment:

Other: Health insurance outreach IT tools

Within-clinic comparison patients

Description:

Community Health Centers that implemented health insurance outreach IT tools: active patients on whom tools were not used

Control clinic comparison patients

Description:

Matched Community Health Centers that did not implement health insurance outreach IT tools: active patients