评估德国一个采用定制干预措施的风险评估系统的影响：一项匹配对照前瞻性研究方案。

Evaluating the Impact of a Risk Assessment System With Tailored Interventions in Germany: Protocol for a Prospective Study With Matched Controls.

作者信息

Pijl Marten, Op den Buijs Jorn, Landgraf Andreas

机构信息

Collaborative Care Solutions Department, Philips Research, Eindhoven, Netherlands.

Philips GmbH, Hamburg, Germany.

出版信息

JMIR Res Protoc. 2020 Oct 1;9(10):e17584. doi: 10.2196/17584.

DOI:10.2196/17584

PMID:33001038

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7563626/

Abstract

BACKGROUND

With a worldwide increase in the elderly population, and an associated increase in health care utilization and costs, preventing avoidable emergency department visits and hospitalizations is becoming a global priority. A personal emergency response system (PERS), consisting of an alarm button and a means to establish a live connection to a response center, can help the elderly live at home longer independently. Individual risk assessment through predictive modeling can help indicate what PERS subscribers are at elevated risk of hospital transport so that early intervention becomes possible.

OBJECTIVE

The aim is to evaluate whether the combination of risk scores determined through predictive modeling and targeted interventions offered by a case manager can result in a reduction of hospital admissions and health care costs for a population of German PERS subscribers. The primary outcome of the study is the difference between the number of hospitalizations in the intervention and matched control groups.

METHODS

As part of the Sicher Zuhause program, an intervention group of 500 PERS subscribers will be tracked for 8 months. During this period, risk scores will be determined daily by a predictive model of hospital transport, and at-risk participants may receive phone calls from a case manager who assesses the health status of the participant and recommends interventions. The health care utilization of the intervention group will be compared to a group of matched controls, retrospectively drawn from a population of PERS subscribers who receive no interventions.

RESULTS

Differences in health care utilization and costs between the intervention group and the matched controls will be determined based on reimbursement records. In addition, qualitative data will be collected on the participants' satisfaction with the Sicher Zuhause program and utilization of the interventions offered as part of the program.

CONCLUSIONS

The study evaluation will offer insight into whether a combination of predictive analytics and case manager-driven interventions can help in avoiding hospital admissions and health care costs for PERS subscribers in Germany living at home independently. In the future, this may lead to improved quality of life and reduced medical costs for the population of the study.

TRIAL REGISTRATION

Deutsches Register Klinischer Studien (DRKS), DRKS00017328; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017328.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17584.

摘要

背景

随着全球老年人口增加，以及随之而来的医疗保健利用率和成本上升，预防可避免的急诊科就诊和住院正成为全球优先事项。个人应急响应系统（PERS）由一个报警按钮和一种与响应中心建立实时连接的方式组成，可帮助老年人更长时间地独立居家生活。通过预测模型进行个体风险评估有助于指出哪些PERS用户有更高的住院转运风险，从而使早期干预成为可能。

目的

目的是评估通过预测模型确定的风险评分与个案管理员提供的针对性干预措施相结合，是否能降低德国PERS用户群体的住院率和医疗保健成本。该研究的主要结局是干预组和匹配对照组的住院次数差异。

方法

作为Sicher Zuhause项目的一部分，500名PERS用户的干预组将被跟踪8个月。在此期间，医院转运预测模型将每天确定风险评分，高危参与者可能会接到个案管理员的电话，个案管理员会评估参与者的健康状况并推荐干预措施。干预组的医疗保健利用率将与一组匹配对照组进行比较，该对照组是从未接受干预的PERS用户群体中回顾性抽取的。