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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Dosage and outcomes in a complex care intervention.

Dawn Wiest¹, Qiang Yang, Teagan Kuruna

¹Camden Coalition, 800 Cooper St, 7th Floor, Camden, NJ 08102.

The American Journal of Managed Care

|June 21, 2023

Summary

Higher intervention dosage in care management programs for complex patients is linked to fewer hospital readmissions within 90 days. Measuring patient engagement and intervention intensity is crucial for effective program evaluation.

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Area of Science:

Healthcare Management
Public Health
Health Services Research

Background:

Care management programs aim to improve outcomes for patients with complex health and social needs.
Evaluating the effectiveness of these programs often requires understanding the intensity of interventions delivered.
Patient engagement and intervention dosage are key metrics for assessing program impact.

Purpose of the Study:

To examine the relationship between intervention dosage and hospital utilization among patients in a care management program.
To highlight the significance of measuring patient engagement and intervention dosage in program evaluation.

Main Methods:

Secondary analysis of data from a randomized controlled trial (2014-2018).
Categorized 393 patients into low- and high-dosage groups based on cumulative care team hours.
Utilized propensity score reweighting to compare hospital utilization outcomes.

Main Results:

High-dosage group showed significantly lower 30-day (21.6% vs 36.6%) and 90-day (41.7% vs 55.2%) readmission rates.
No statistically significant difference in 180-day readmission rates between groups (57.5% vs 64.9%).

Conclusions:

A higher intervention dosage in care management is associated with reduced short-term hospital readmissions.
Medical complexity and social factors can influence the long-term dose-response relationship.
Further research is needed to refine evaluation methods for complex patient care management.