Identifying Optimal Acute Care Comparators to Inform the Evaluation of an Advanced Care at Home Pilot Program

BACKGROUND: Hospital at Home (HH) programs-which seek to deliver acute care within a patient's home-have become more prevalent over time. However, existing literature exhibits heterogeneity in program structure, evaluation design, and target population size, making it difficult to draw generalizable conclusions to inform future H@H program design.

OBJECTIVE: The objective of this work was to develop a quality improvement evaluation strategy for a HH program-the Kaiser Permanente Advanced Care at Home (KPACAH) program in Northern California-leveraging electronic health record data, chart review, and patient surveys to compare KPACAH patients with inpatients in traditional hospital settings.

METHODS: The authors developed a 3-step recruitment workflow that used electronic health record filtering tools to generate a daily list of potential comparators, a manual chart review of potentially eligible comparator patients to assess individual clinical and social criteria, and a phone interview with patients to affirm eligibility and interest from potential comparator patients.

RESULTS: This workflow successfully identified and enrolled a population of 446 comparator patients in a 5-month period who exhibited similar demographics, reasons for hospitalization, comorbidity burden, and utilization measures to patients enrolled in the KPACAH program.

CONCLUSION: These initial findings provide promise for a workflow that can facilitate the identification of similar inpatients hospitalized at traditional brick and mortar facilities to enhance outcomes evaluations for the HH programs, as well as to identify the potential volume of enrollees as the program expands.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:27

Enthalten in:

The Permanente journal - 27(2023), 4 vom: 15. Dez., Seite 90-99

Sprache:

Englisch

Beteiligte Personen:

Elliott, Martin [VerfasserIn]
Rinetti-Vargas, Gina [VerfasserIn]
Kipnis, Patricia [VerfasserIn]
Herm, Ariel R [VerfasserIn]
Wong, Kent [VerfasserIn]
Witkowski, Agnieszka [VerfasserIn]
Deputy, Jesica [VerfasserIn]
Reyes, Vivian [VerfasserIn]
Barreda, Fernando [VerfasserIn]
Myers, Laura C [VerfasserIn]
Liu, Vincent X [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 16.12.2023

Date Revised 21.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.7812/TPP/23.059

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM363773088