- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT02922855
Incentives for Primary Care Use in a Safety Net Setting
Incentives for Primary Care Use: A Randomized Controlled Trial in a Safety Net Setting
Panoramica dello studio
Stato
Intervento / Trattamento
Descrizione dettagliata
A randomized controlled trial (RCT) of incentives for an initial primary care visit within 6 months of enrollment in a health care coverage program. Study subjects are drawn from a low-income adult population that gains coverage and access to community-based primary care services under a program administered by an academic safety-net hospital. The investigators will offer financial incentives to encourage an initial primary care visit within 6 months of enrollment and evaluate whether the primary care visit altered subsequent health seeking behavior and influenced patient satisfaction and other outcomes such as self-reported health status.
Incentives should steer patients in their decision to seek primary care, reduce barriers to care, and ultimately improve patient health and reduce utilization and costs through their relationship with a PCP. This study is the first of its kind to incentivize low-income patients. This population has the greatest need for health care and exerts the greatest pressure on the United States' safety net system. Furthermore, the safety net population is the target of policies such as Medicaid eligibility expansions, yet urban safety net patients are largely understudied. These patients are rarely given the opportunity to participate in research, and when they are the subjects of measures to reduce health care utilization, they are the subject of policies using negative incentives such as those that introduce cost sharing for using ED services.1 Alternatively, safety net providers invest in case management systems to reduce utilization. The proposed study is a departure from prior measures to reduce utilization among low-income patients by focusing on patients and using positive incentives. The study borrows from the principles of behavioral economics to motivate patients towards primary care utilization. Once in the primary care system, The investigators will test whether primary care contact reduces more expensive forms (e.g., inpatient, ED) of health care.
The investigators will compare outcomes of patients assigned in the highest incentive group ($50) to patients assigned to the modest incentive group ($25) and to patients assigned to usual care (no incentive, but assignment to a PCP). The investigators will also compare incentive patients ($50, $25) to a contemporaneous group of patients that enroll in the safety net clinic at the same time.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Non applicabile
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Adults between ages 21-64 years
- No prior enrollment in VCC for the past 12 months
- English or Spanish speaking, and
- Can be contacted by mail and telephone (preferably) or willing to be interviewed in person.
Exclusion Criteria:
- Unable to be contacted by phone/mail
- Cannot provide consent
- No longer located in catchment area
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Ricerca sui servizi sanitari
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
---|---|
Nessun intervento: Contemporaneous Control
This group is our 'usual care' control group.
They were not contacted for an interview and were not offered an incentive to visit their primary care physician.
|
|
Comparatore attivo: $0 group
This group completed a baseline interview but was not offered any incentive if they visited their primary care physician.
|
Those assigned to the $0 group will not receive an incentive for visiting their PCP.
|
Sperimentale: $25 group
This group completed a baseline interview and was offered $25 they visited their primary care physician within 6 months.
|
Those assigned to the $25 group will receive $25 if they visit their PCP within 6 months of study enrollment.
|
Sperimentale: $50 group
This group completed a baseline interview and was offered $50 they visited their primary care physician within 6 months.
|
Those assigned to the $50 group will receive $50 if they visit their PCP within 6 months of study enrollment.
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
The number of Primary Care Physician visits will be assessed using medical claims record data.
Lasso di tempo: This will be assessed in the 6 months following study enrollment.
|
The number of primary care visits to a primary care physician will be collected from medical claims record data.
|
This will be assessed in the 6 months following study enrollment.
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
The time to a Primary Care Physician will be assessed using medical claims record data.
Lasso di tempo: This will be assessed in the 6 months following study enrollment.
|
The time to a primary care visits to a primary care physician will be collected from dates available in the medical claims record data.
|
This will be assessed in the 6 months following study enrollment.
|
Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Cathy Bradley, Phd, PI
Studiare le date dei record
Studia le date principali
Inizio studio
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Altri numeri di identificazione dello studio
- HM20000002
- 1R01HS022534 (Sovvenzione/contratto AHRQ degli Stati Uniti)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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