Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
1201 participants
OBSERVATIONAL
2019-11-07
2022-09-22
Brief Summary
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Detailed Description
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Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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HealthFirst Intervention
Patients attributed to HealthFirst who will receive the intervention
Supportive care program
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.
HealthFirst Control
Patients attributed to HealthFirst who will not receive the intervention
No interventions assigned to this group
Mortality Model Intervention
Patients who are identified as High Risk by the mortality predictive model and who receive the intervention.
Supportive care program
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.
Mortality Model Control
Patients who are identified as High Risk by the mortality predictive model and who do not receive the intervention.
No interventions assigned to this group
Interventions
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Supportive care program
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.
Eligibility Criteria
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Inclusion Criteria
* at or above the 75th percentile on the Mortality Model
* Attributed to a value based contract
Exclusion Criteria
* Below the 75th percentile on the Mortality Model
* Not attributed to a value based contract
18 Years
ALL
No
Sponsors
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NYU Langone Health
OTHER
Responsible Party
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Principal Investigators
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Leora Horwitz, MD
Role: PRINCIPAL_INVESTIGATOR
NYU Langone Health
Locations
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NYU Langone Health
New York, New York, United States
Countries
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Other Identifiers
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QI-High Risk
Identifier Type: -
Identifier Source: org_study_id
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