Breaking News
November 21, 2018 - Many people underestimate the impact of sprains, say foot scientists
November 21, 2018 - Lower levels of protein make squamous carcinoma cells more invasive
November 21, 2018 - Study highlights a new predictor of type 2 diabetes
November 21, 2018 - New low-cost injectable hydrogel could help wounds heal faster
November 21, 2018 - Merck Announces Winners of 2018 Life Science Awards
November 21, 2018 - Amount of weight regain after bariatric surgery helps predict health risks
November 21, 2018 - Heart failure patients with stronger hearts have more depressive symptoms, lower quality of life
November 21, 2018 - Women can be as resilient as men in undertaking arduous physical activity
November 21, 2018 - Receptor structure could be key to developing new osteoporosis drugs
November 21, 2018 - Researchers identify human white matter pathway associated with individual variability in human stereoacuity
November 21, 2018 - Vitamin D critical to early development of vertebrates, study suggests
November 21, 2018 - Myriad biological, societal factors that impact CKD severity for children of African descent
November 21, 2018 - Isofol Announces Initiation of a Pivotal Phase 3 Clinical Trial of arfolitixorin for the Treatment of Metastatic Colorectal Cancer
November 21, 2018 - Experts offer more clarity on managing common ankle fractures
November 21, 2018 - About 300 million bits of DNA are missing from basic reference genome, report scientists
November 21, 2018 - Study explores how the moving brain processes visual information
November 21, 2018 - Biomedical engineers stop cancer cells from moving and spreading
November 21, 2018 - Gut protein mutations protect against spikes in blood glucose levels
November 21, 2018 - First probabilistic atlas of thalamus nuclei to better understand the brain
November 21, 2018 - Peanut allergies could soon have a drug treatment
November 21, 2018 - Vanderbilt researchers isolate antibody that can neutralize West Nile virus
November 21, 2018 - KHN’s ‘What the Health?’ Health nerd books for the holidays
November 21, 2018 - MDMA could help gain trust but does not make one naive find researchers
November 21, 2018 - Study uncovers new mechanism controlling the master cancer regulator
November 21, 2018 - Online communication technologies could stave off depression among seniors, shows study
November 21, 2018 - FDA Approves Gamifant (emapalumab-lzsg) for Primary Hemophagocytic Lymphohistiocytosis
November 21, 2018 - Artificial intelligence predicts treatment effectiveness
November 21, 2018 - A bicyclist’s road to recovery after traumatic brain injury
November 21, 2018 - New research project to combat obesity, type 2 diabetes receives NIH funding
November 21, 2018 - Humans play key role in distribution and transmission of Bartonella bacteria
November 21, 2018 - First modeling system developed for testing age-specific human immune responses to vaccines
November 21, 2018 - FDA Alert: Gilenya (fingolimod): Drug Safety Communication
November 21, 2018 - Uric Acid Test: MedlinePlus Lab Test Information
November 21, 2018 - Researchers use genetics to predict response to antipsychotic medications
November 21, 2018 - Proposal to include the price of drugs in television ads is flawed, Stanford scholar writes
November 21, 2018 - Disrupting reproduction strategy of disease-causing parasites could help fight malaria
November 20, 2018 - ACAAI: Almost 2 Percent of Children Have Milk Allergy
November 20, 2018 - Congenital anomalies of kidney and urinary tract – Genetics Home Reference
November 20, 2018 - Can video games improve the health of older adults with schizophrenia?
November 20, 2018 - Can flicking a molecular switch restore the aging immune system’s competence?
November 20, 2018 - Restek launches new Oregon cannabis pesticide standards
November 20, 2018 - Health sector coalition urges Government to safeguard patients in future UK-EU relationship
November 20, 2018 - Study evaluates second-hand marijuana smoke exposure among children
November 20, 2018 - Scientists identify three genes responsible for recurrent molar pregnancies
November 20, 2018 - Researchers identify multisystem disorder caused by bi-allelic variants in CCDC47 gene
November 20, 2018 - Dining Out With Allergies Is Tough, But These Steps Can Help
November 20, 2018 - Breastfeeding protects infants from antibiotic-resistant bacteria
November 20, 2018 - AI matched, outperformed radiologists in screening X-rays for certain diseases | News Center
November 20, 2018 - Adolescents increasingly choose marijuana over cigarettes, alcohol
November 20, 2018 - World’s first medical imaging scanner produces diagnostic scan of the whole human body
November 20, 2018 - Cytocybernetics receives NIMH award to move into neuronal drug development
November 20, 2018 - Researchers discover new information on pathological mechanisms of Alzheimer’s disease
November 20, 2018 - ‘Unknown’ enzyme may be key to new treatment for inflammatory diseases
November 20, 2018 - Recreational drug may help people regain trust in others
November 20, 2018 - Researchers identify gene vital for post-stroke recovery
November 20, 2018 - Scientists identify novel target for neuron regeneration, functional recovery in spinal cord injury
November 20, 2018 - Potential new therapeutic approach developed for synovial sarcoma
November 20, 2018 - Skeletal imitation reveals how bones grow atom-by-atom
November 20, 2018 - Autism behaviors show unique brain network fingerprints in infants
November 20, 2018 - Location matters for inflammation clearance
November 20, 2018 - Towards finding a druggable cancer target
November 20, 2018 - Ultragenyx Announces Intent to Submit New Drug Application to U.S. FDA for UX007 for the Treatment of Long-chain Fatty Acid Oxidation Disorders in Mid-2019
November 20, 2018 - Cooling ‘brains on fire’ to treat Parkinson’s
November 20, 2018 - Less pollution could increase the average lifespan of Copenhageners by an entire year in 2040
November 20, 2018 - Abramson Cancer Center becomes the 28th member institution of National Comprehensive Cancer Network
November 20, 2018 - The plug and play time-resolved spectrometer from PicoQuant
November 20, 2018 - Breakthrough technology offers new hope to people with glaucoma, retinitis and macular degeneration
November 20, 2018 - New report highlights key focus areas to help cancer screening realize its full potential
November 20, 2018 - International experts to discuss strategies to maintain spatial orientation in old age
November 20, 2018 - Low-protein, high-carb diet may promote healthy brain ageing
November 20, 2018 - Scientists discover new inhibitor that decreases lung inflammation
November 20, 2018 - Participation project calls for relaxing research ban on germline interventions
November 20, 2018 - Karyopharm’s Selinexor Receives Fast Track Designation from FDA for the Treatment of Patients with Relapsed or Refractory Diffuse Large B-cell Lymphoma
November 20, 2018 - Arthritis by the Numbers: Book of Trusted Facts & Figures
November 20, 2018 - Drug homing method helps rethink Parkinson’s
November 20, 2018 - AHF commends the passage of global AIDS funding in the House, calls for swift approval
November 20, 2018 - The search for new psychiatric disorder treatments
November 20, 2018 - New research offers hope for simpler way to diagnose and treat cancer
November 20, 2018 - Study sheds light on the infection mechanism of influenza virus
November 20, 2018 - Storage failures of eggs and embryos gain a new perspective
Comprehensive care physician model reduces hospitalization and expense for high risk patients

Comprehensive care physician model reduces hospitalization and expense for high risk patients

image_pdfDownload PDFimage_print

Patients who need frequent hospitalization account for a disproportionate amount of health care spending in the United States. In 2012, the University of Chicago Medicine — funded by a Health Care Innovation Award from the Center for Medicare & Medicaid Innovation — began enrolling patients in a clinical trial designed to test an imaginative way to reduce such hospital stays.

The study, featured in the May 20, 2018, New York Times Sunday Magazine, was designed to determine whether doctors who focus their practices on the care of patients in and out of the hospital, known as comprehensive care physicians (CCPs), could improve care while reducing hospitalization for a highly vulnerable set of patients at high risk for being hospitalized.

The core element of the CCP model is that the same physician provides care for patients in the clinic as well as in the hospital. A few CCPs even make house calls. The CCPs also lead a team of nurse practitioners, social workers, care coordinators and other specialists selected for their ability to address the needs of high-risk patients. Each physician carries a panel of approximately 200 patients at a time, serving as their primary care physician during clinic visits and supervising their care whenever they are hospitalized.

From November 2012 to June 2016, 2,000 patients with chronic health problems enrolled in the study. Most came from the South Side of Chicago. Most of them had at least one hospital stay in the previous year. All of these patients were covered by Medicare.

The model is built upon 15 years of research by study director David Meltzer, MD, PhD, professor of medicine at the University of Chicago and chief of hospital medicine, and colleagues, on the changing medical work force in the United States. The model was designed to provide better care at lower cost. In this pilot study, it was able to improve the continuity of patient care, especially during and after a hospital stay, as well as strengthen the bond between doctor and patient.

Half of the patients in the study were assigned to “standard care.” They connected with a hospital-based primary care physician who saw patients as needed in the clinic, but did not directly take care of them if they were admitted to the hospital. The other half were assigned to one of five CCPs, who saw them during clinic visits and also cared for them in the hospital.

When the study was completed, it was evident that the CCP model was both preferred by patients and economically beneficial in terms of reducing health care utilization.

“Hospitalization rates for CCP patients were 15 to 22 percent lower than for standard care patients,” said Meltzer. CCP patients also reported “a better experience,” he added. They gave their physicians higher ratings on the Hospital Consumer Assessment of Healthcare Providers and Systems, a patient satisfaction survey required for all hospitals by the Centers for Medicare and Medicaid Services.

The University’s standard care physicians scored quite well, in the 80th percentile nationally, but the CCP doctors were in the 95th percentile. They also were ranked higher by patients dealing with mental health issues.

“There’s a huge literature suggesting that elements of the doctor-patient relationship, including trust, interpersonal relations, communication and knowledge of the patient, are all associated with lower costs and better outcomes,” Meltzer said.

The trial, still underway, enrolls patients who are predicted to spend an average of 10 days a year in the hospital. Many of these patients have chronic diseases. Others are geriatric patients living in residence homes or patients with renal disease requiring regular dialysis treatment.

This program “may improve patient experience and health status while substantially reducing utilization for patients at increased risk for hospitalization,” the study authors conclude. “The CCP model warrants further exploration through efforts to implement it in additional settings and rigorously evaluate its effects on outcomes and costs.”

“Our goal is to understand patients’ needs so that we can give them the most appropriate care,” said Meltzer. “That should be better for them, produce better outcomes and ultimately be less costly for the health care system.”

The next step is an expanded program, the Comprehensive Care, Community & Culture Program (C4P), designed to reduce the unmet social needs of economically and socially disadvantaged patients. About 400 people have already enrolled.

Source:

http://www.uchospitals.edu/

Tagged with:

About author

Related Articles