Effects Of Income Supplements On 30-Day Readmissions For Vulnerable Older Adults

NCT05807750 | Terminated DMC

• 2 other identifiers: 2023-001 Sonik Readmit RCTP30AG024968
• Study Type: interventional
• Target: 8
• Locations: 1 country
• Sites: 1

Brief Summary

Unplanned 30-day hospital readmissions are an critical healthcare quality metric, with meaningful effects on patients and health systems operations. Interventions to reduce unplanned readmissions have primarily operated within a healthcare-centric frame, with enhancements to either pre- or post-discharge care planning, medication reconciliation, or visit frequency. Associations of 30-day readmission rates with poverty status and other social factors, however, suggest that attending to unmet social needs may yield added benefits to models focused on healthcare delivery. The purpose of the present trial is to provide evidence regarding the effects on 30-day readmissions of providing a one-time post-discharge income supplement to socially vulnerable older adults with medical complexity participating in an enhanced care coordination program.

Conditions

Patient Readmission

Keywords

Patient Readmission; Income

Outcome Measures

Primary Outcomes (1)

• Unplanned 30-day readmission

  Whether a participant has an unplanned readmission within 30 days of the index hospital discharge

  Within 30 days of the index hospital discharge

Secondary Outcomes (5)

• 30-day post-discharge medical expenditures

  Within 30 days of the index hospital discharge

• 90-day post-discharge medical expenditures

  Within 90 days of the index hospital discharge

• 30-day post-discharge medical readmission OR emergency department visit

  Within 30 days of the index hospital discharge

• 90-day post-discharge medical readmission OR emergency department visit

  Within 90 days of the index hospital discharge

• Unplanned 90-day readmission

  Within 90 days of the index hospital discharge

Other Outcomes (1)

• Post-discharge care plan adherence

  Within 90 days of the index hospital discharge

Study Arms (2)

Control

ACTIVE COMPARATOR

Enhanced care planning only (plus $15 as compensation for participation)

Other: Enhanced care planning

Intervention

EXPERIMENTAL

Enhanced care planning plus a one-time $300 post-discharge income supplement

Other: Post-discharge income supplement; Other: Enhanced care planning

Interventions

Post-discharge income supplement OTHER

$300 income supplement

Intervention

Enhanced care planning OTHER

Enhanced care planning provided by a nurse care manager

Control; Intervention

Eligibility Criteria

• Age: 55 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• A participant in the underlying enhanced care planning program
• aged 55 years or older
• attending an outpatient clinic appointment as part of the underlying enhanced care planning program within 10 days of being discharged from an inpatient hospital stay
• able to understand the study consent form (with interpretation services if needed)

You may not qualify if:

• The candidate is not discharged from the index admission to a community setting (e.g., they will be excluded if they are discharged to a skilled nursing facility)
• The candidate has a legal guardian with control over financial decision-making
• The candidate has been approached about the study during a previous encounter
• The index hospitalization was a planned admission

Sponsors & Collaborators

• AltaMed Health Services Corporation: lead
• National Institute on Aging (NIA): collaborator
• University of Southern California: collaborator

Study Sites (1)

AltaMed Health Services Corporation

Los Angeles, California, 90040, United States

Location

Related Publications (1)

• Calvillo-King L, Arnold D, Eubank KJ, Lo M, Yunyongying P, Stieglitz H, Halm EA. Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: systematic review. J Gen Intern Med. 2013 Feb;28(2):269-82. doi: 10.1007/s11606-012-2235-x. Epub 2012 Oct 6.

  PMID: 23054925 BACKGROUND

Study Officials

• Rajan A Sonik, PhD, JD, MPH

  Brandeis University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 23, 2023
• First Posted: April 11, 2023
• Study Start: June 21, 2023
• Primary Completion: April 22, 2024
• Study Completion: April 22, 2024
• Last Updated: June 3, 2024

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)