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Related Experiment Video

Updated: Nov 12, 2025

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Comparative Effectiveness of a Complex Care Program for High-Cost/High-Need Patients: a Retrospective Cohort Study.

Douglas W Roblin1, Joel E Segel2, Richard J McCarthy3

  • 1Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA. Douglas.W.Roblin@KP.Org.

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A Complex Care Program (CCP) for high-cost/high-need adults significantly reduced short-term mortality risk. This patient-centered model improved survival but did not impact hospital admission rates within 180 days.

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Area of Science:

  • Healthcare management
  • Patient-centered care models
  • Complex care interventions

Background:

  • High-cost/high-need (HCHN) adults often strain healthcare systems.
  • Patient-centered care models may improve outcomes for HCHN populations.
  • Coordinated clinical and social services are key for HCHN patients.

Purpose of the Study:

  • To evaluate the impact of a Complex Care Program (CCP) on patient survival.
  • To assess the effect of the CCP on hospital admission rates.
  • To determine the 180-day outcomes for patients enrolled in the CCP.

Main Methods:

  • Retrospective cohort study with quasi-experimental design.
  • Propensity score matching compared CCP patients to a concurrent control group.
  • Analysis of time to death and time to first hospital admission within 180 days.

Main Results:

  • CCP patients demonstrated a significantly prolonged time to death (HR: 0.577).
  • CCP decedents had longer survival (median 69.5 vs. 53.0 days, p=0.03).
  • Hospital admission rates were similar between CCP and control groups (HR: 1.081).

Conclusions:

  • The Complex Care Program (CCP) was associated with reduced short-term mortality risk.
  • The CCP intervention showed significant benefits for eligible, participating patients.
  • Further research may explore long-term impacts and broader applicability of CCPs.