Related Experiment Video
Updated: Jul 13, 2026
13:08
Measurement of Fronto-limbic Activity Using an Emotional Oddball Task in Children with Familial High Risk for Schizophrenia
Published on: December 2, 2015
Effectiveness of team-managed home-based primary care: a randomized multicenter trial
S L Hughes1, F M Weaver, A Giobbie-Hurder
1Cooperative Studies Program Coordinating Center, Edward A. Hines Jr Veterans Affairs Hospital, Hines, Ill, USA. shughes@uic.edu
JAMA
|January 9, 2001
Summary
Team-Managed Home-Based Primary Care (TM/HBPC) improved quality of life for terminally ill patients and satisfaction for others. While it reduced readmissions early on, costs increased, requiring a balance of benefits against expenses.
Area of Science:
- Geriatrics
- Health Services Research
- Primary Care
Background:
- Home-based health care's effectiveness is debated.
- Previous Veterans Affairs (VA) Team-Managed Home-Based Primary Care (TM/HBPC) trials showed positive results, but generalizability was uncertain.
Purpose of the Study:
- To evaluate the impact of TM/HBPC on patient functional status.
- To assess health-related quality of life (HR-QoL) and satisfaction with care.
- To determine the effect on the cost of care.
Main Methods:
- Multisite randomized controlled trial (RCT) across 16 VA medical centers (1994-1998).
- 1966 patients (mean age 70) with functional impairments or specific conditions (terminal illness, CHF, COPD).
- Intervention: TM/HBPC with a primary care manager, 24-hour contact, pre-approval for readmissions, and discharge planning support versus usual care.
Main Results:
- No significant difference in functional status (Barthel Index) between groups.
- Terminally ill patients in TM/HBPC showed significant HR-QoL improvements.
- Non-terminally ill patients reported higher satisfaction with care.
- Caregivers of terminal patients experienced improved HR-QoL; caregivers of non-terminal patients reported reduced burden.
- A 22% decrease in hospital readmissions at 6 months for severely disabled patients, but not sustained at 12 months.
- TM/HBPC incurred higher costs (6.8% at 6 months, 12.1% at 12 months).
Conclusions:
- TM/HBPC enhanced HR-QoL for terminally ill patients and satisfaction for non-terminally ill patients.
- Caregiver outcomes improved, including reduced burden.
- Short-term reduction in hospital readmissions was observed, but TM/HBPC did not replace other care forms.
- The increased costs of TM/HBPC must be considered alongside its benefits.
Related Concept Videos
02:01Group Design
The most basic experimental design involves two groups: the experimental group and the control group. The two groups are designed to be the same except for one difference— experimental manipulation. The experimental group gets the experimental manipulation—that is, the treatment or variable being tested—and the control group does not. Since experimental manipulation is the only difference between the experimental and control groups, we can be sure that any differences between the two are due to...
01:13Randomized Experiments
The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...
Simple randomization
Simple...