Primary Palliative Care for Emergency Medicine (PRIM-ER)

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

98922 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-07-01

Study Completion Date

2022-12-31

Brief Summary

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This proposal builds upon the evaluation of Primary Palliative Care Education, Training, and Technical Support for Emergency Medicine (PRIM-ER) implemented in a cluster-randomized, stepped wedge design in 33 Emergency Departments (EDs).

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Detailed Description

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Conditions

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Emergencies

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Beneficiaries with a one-year mortality of at least 30%

The patient cohort will be extracted via the Centers for Medicare and Medicaid Services (CMS) Research Data Assistance Center (ResDAC) using a two-step process to maximize diversity, and minimize intentional or unintentional exclusions based on risk, age, health literacy, demographics, or expected adherence.

healthcare service utilization in the six months following the ED visit

Intervention Type BEHAVIORAL

The analysis of the effect of PRIM-ER on ED disposition using a generalized linear binomial model with random site level effects.

Interventions

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healthcare service utilization in the six months following the ED visit

The analysis of the effect of PRIM-ER on ED disposition using a generalized linear binomial model with random site level effects.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patients must demonstrate one-year mortality of at least 30 percent (score \> 6) according to the Gagne Index, a validated instrument used to measure all cause one-year mortality in community-dwelling older adults, calculated based on their prior 12 months before the index ED visit of Medicare claims.

Exclusion Criteria

* ED patients transferred from a nursing home on the index ED visit will be excluded since prediction of mortality and disposition of such patients differs from community-dwelling adults.
* Patients currently receiving hospice at the time of the index ED visit will also be excluded since they have already received services.

Minimum Eligible Age

66 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No