A Multi-Site Randomized Trial of Team Managed Home-Based Primary Care

Weaver FM. A Multi-Site Randomized Trial of Team Managed Home-Based Primary Care. Paper presented at: American Public Health Association Annual Meeting and Exposition; 1999 Nov 1; Chicago, IL.

OBJECTIVE(S):The primary objective of this study is to determine whether team-managed hospital based home care (TM/HBPC), including active physician participation, will be less costly yet provide similar or higher quality care than customary care for high hospital users. The secondary objectives of this study is to determine whether, for these high hospital users, TM/HBPC 1. Will not decrease the patient's fuctional status 2. Will equal or increase satisfaction with care as expressed by both the patients and caregivers 3. Will equal or increase the patient's quality of life (health status) and 4. Will not increase the caregiver's level of burden.METHODS:50-50 chance) to either TM/HBPC or customary care. The intervention will consist of targeting to subgroups of high users of hospital facilities (the severely disabled and the terminally ill) and managing patient care using an interdisciplinary team. The TM/HBPC team must minimally include and M.D., nurse, and social worker where the TM/HBPC physician in actively involved, and where there is a 24-hour TM/HBPC contact available to patients. Patients will be followed for one year with interviews to determine the impact of treatment on the patient's functional status, patient and caregiver satisfaction, and the caregiver burden at one, six and twelve months. Also patients' use of all VA and private sector health care will be tracked to determine hospital use and cost.