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Related Concept Videos

Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
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Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
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Crossover experiments, also called the repeated-measurements design, is a study design in which all experimental units are exposed to all treatments in different periods. Crossover experiments are generally used in psychology, the pharmaceutical industry, agriculture, and medicine.
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Related Experiment Video

Updated: Jan 13, 2026

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
04:24

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Published on: April 19, 2019

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

Douglas W Roblin1, Joel E Segel2, Haihong Hu1

  • 1Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD.

Medical Care
|January 8, 2026
PubMed
Summary
This summary is machine-generated.

A complex care program (CCP) for seriously ill patients in an integrated health system reduced the risk of death by 29% compared to usual primary care (UPC). This finding was replicated in a second cohort, confirming CCP benefits for high-need individuals.

Keywords:
frailtymanaged caremortalitymultimorbidityprimary careseriously ill patients

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Area of Science:

  • Health Services Research
  • Primary Care Models
  • Patient Outcomes

Background:

  • Evidence on alternative primary care models for high-cost, high-needs patients is inconsistent.
  • This study evaluates a complex care program (CCP) within an integrated delivery system for seriously ill adults.

Purpose of the Study:

  • To assess the impact of a complex care program (CCP) on patient mortality.
  • To replicate findings from a prior cohort study on the effectiveness of CCP for seriously ill adults.

Main Methods:

  • A quasi-experimental design compared 180-day mortality between CCP patients (n=1445) and usual primary care (UPC) patients (n=6409).
  • Propensity score matching was used to create comparable groups based on demographics, comorbidities, and frailty.
  • Cox proportional hazards regression estimated the hazard of mortality in matched samples (n=1440 per group).

Main Results:

  • The CCP continued to enroll patients with higher comorbidity and frailty levels compared to the UPC eligible population.
  • In the matched samples, CCP patients demonstrated a significantly lower hazard of 180-day mortality (HR: 0.71, 95% CI: 0.61-0.82).
  • The observed hazard ratio was higher than in the prior inception cohort (HR: 0.58, 95% CI: 0.47-0.70).

Conclusions:

  • The reduced hazard of death associated with the complex care program (CCP) was reproduced in a second incident cohort.
  • CCP in an integrated health care system shows continued benefit for seriously ill adult patients compared to usual primary care.