Related Experiment Video
Updated: Aug 11, 2026
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Effects of a program for coordinated care of advanced illness on patients, surrogates, and healthcare costs: a
Joseph B Engelhardt1, Kimberly P McClive-Reed, Ronald W Toseland
1Center for Advanced Illness Coordinated Care, Veterans Affairs Health Care Network/Upstate New York, 113 Holland Ave (11T), Albany, NY 12208, USA.
Objective:
To evaluate the Advanced Illness Coordinated Care Program (AICCP), delivered by allied health personnel to improve care for patients coping with advanced illness and in need of preparation for end-of-life (EOL) care.
Study Design:
Clinical trial involving 275 patients and 143 surrogates in 6 settings who were randomly assigned to the AICCP or usual care (UC).
Methods:
The AICCP participants met with a care coordinator for assistance with provider communication, care coordination, and support. The AICCP was evaluated for effects on satisfaction with care, advance planning, consistency of care with patient preferences, and healthcare costs.
Results:
The AICCP increased patient satisfaction with care and communication (P = .03), and AICCP surrogates reported fewer problems with provider support (P = .03). More AICCP than UC participants completed an advance directive (AD) (69.4% vs 48.4%; P = .006), and the AICCP group completed more ADs per participant (P = .01). Median time to AD documentation was 46 days for AICCP and 238 days for UC (P = .02). There was no difference in survival (AICCP 43% vs UC 42%). Six-month costs were lower with AICCP than with UC (12,123 US dollars vs 16,295 US dollars); however, the difference did not reach statistical significance.
Conclusions:
The AICCP improved satisfaction with care and helped patients develop and revise more ADs, sooner, without affecting mortality. This program may be delivered in a range of managed care, fee-for-service, and group-model settings.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:21Cancer Survival Analysis
01:25Continuing Care
01:15Bioavailability Study Design: Healthy Subjects Versus Patients
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities