Improving Service Delivery Through Access Points

NCT ID: NCT00012623

Last Updated: 2015-04-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

39481 participants

Study Classification

OBSERVATIONAL

Study Completion Date

2002-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

CBOCs represent one of VA's main managed care strategies for shifting the focus of care from the inpatient to the outpatient setting and for improving the health of our nation's veterans. Hypothesis-driven research is critically needed to test the basic assumptions motivating the expansion of CBOCs throughout the VA health care system.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background:

CBOCs represent one of VA's main managed care strategies for shifting the focus of care from the inpatient to the outpatient setting and for improving the health of our nation's veterans. Hypothesis-driven research is critically needed to test the basic assumptions motivating the expansion of CBOCs throughout the VA health care system.

Objectives:

The purpose was to determine how increased geographic access to primary care services affects service use and costs. Two specific aims addressed were: 1) to determine how CBOCs impact the service use of all existing users and existing users with the following ambulatory care sensitive conditions (ACSC): alcohol dependence, angina, chronic obstructive pulmonary disease (COPD), depression, diabetes and hypertension; and 2) to describe how CBOCs affect the workload and costs of the VA health care system from the VISN's perspective.

Methods:

A quasi-experimental pre-post study design with intervention and reference groups was employed to compare service use and costs in the 18 months following the establishment of a new CBOC. Fifteen CBOCs from 11 VISNs were included in the analysis. For specific aim 1, the intervention group was defined as existing users in the catchment area of a new CBOC and the reference group was defined as matched existing users outside CBOC catchment areas. Multivariate statistical regression analyses were used to estimate the impact of residing within the CBOC catchment area on use and cost in the post-period, controlling for patient casemix and use/cost in the 18 month pre-period. For specific aim 2, the intervention group was defined as zip codes in the catchment area of a new CBOC and the reference group was defined as matched zip codes outside CBOC catchment areas. Average use and costs for all users, existing users and new users from intervention zip codes and reference zip codes were compared.

Status:

Complete.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hypertension Angina Diabetes

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Study Time Perspective

RETROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Group 1

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Subjects must live in the catchment area of a specified CBOC and have been diagnosed with a tracer condition.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

US Department of Veterans Affairs

FED

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

John C. Fortney, PhD

Role: PRINCIPAL_INVESTIGATOR

Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR

No. Little Rock, Washington, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Fortney JC, Maciejewski ML, Warren JJ, Burgess JF Jr. Does improving geographic access to VA primary care services impact patients' patterns of utilization and costs? Inquiry. 2005 Spring;42(1):29-42. doi: 10.5034/inquiryjrnl_42.1.29.

Reference Type RESULT
PMID: 16013585 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

ACC 97-068

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Video Vitals and Biomarkers
NCT06136156 COMPLETED