Primary Palliative Care for Emergency Medicine (PRIM-ER)

NYU Langone Health98,922 enrolled

Overview

This proposal builds upon the evaluation of Primary Palliative Care Education, Training, and Technical Support for Emergency Medicine (PRIM-ER) implemented in a cluster-randomized, stepped wedge design in 33 Emergency Departments (EDs).

Study Type

OBSERVATIONAL

Enrollment

98,922

Conditions

Emergencies

Interventions

healthcare service utilization in the six months following the ED visitBEHAVIORAL

The analysis of the effect of PRIM-ER on ED disposition using a generalized linear binomial model with random site level effects.

Eligibility

Sex: ALLMin age: 66 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients must demonstrate one-year mortality of at least 30 percent (score \> 6) according to the Gagne Index, a validated instrument used to measure all cause one-year mortality in community-dwelling older adults, calculated based on their prior 12 months before the index ED visit of Medicare claims. Exclusion Criteria: * ED patients transferred from a nursing home on the index ED visit will be excluded since prediction of mortality and disposition of such patients differs from community-dwelling adults. * Patients currently receiving hospice at the time of the index ED visit will also be excluded since they have already received services.

Locations (1)

New York University School of Medicine

New York, New York, United States

Outcomes

Primary Outcomes

Acute Care Admission

Proportion of eligible patients whose disposition is to an acute care setting (inpatient, non-palliative service).

Time frame: Index Visit

Secondary Outcomes

Proportion of Patients With Emergency Department (ED) Revisits

Measured as the proportion of patients with at least one ED revisit in the six months following the index ED visit (Count)

Time frame: Up to Month 6

Inpatient Days

Measured as the proportion of patients who had at least one inpatient stay in the six months following the index ED visit (Count).

Time frame: Up to Month 6

Home Health Use

Proportion of patients with any home health use in the six months following the index ED visit (Yes/No)

Time frame: Up to Month 6

Hospice Use

Proportion of patients with any hospice use in the six months following the index ED visit (Yes/No).

Time frame: Up to Month 6

Proportion of Patients Who Died at Month 6 Post-Index Visit

Time frame: Up to Month 6

Survival: Time-to-event

Number of days from index ED visit to death among those who died within six months following the index ED visit (Count of days)

Time frame: Up to Month 6

Data from ClinicalTrials.gov

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