Trial reportJournal of the American Geriatrics Society2014
Cost analysis of a home-based nurse care coordination program.
Trial report in Journal of the American Geriatrics Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Improving Patients' Medication Adherence and Outcomes in Nonhospital Settings Through eHealth: Systematic Review of Randomized Controlled Trials.Journal of medical Internet research · 2020Pooled it
- Enhanced coordination of care to reduce medication risks in older home care clients in primary care: a randomized controlled trial.BMC geriatrics · 2019Trial
- Potentially Preventable Spending Among High-Cost Medicare Patients: Implications for Healthcare Delivery.Journal of general internal medicine · 2020Article
- The effects of home-based primary care on Medicare costs at Spectrum Health/Priority Health (Grand Rapids, MI, USA) from 2012-present: a matched cohort study.BMC health services research · 2018Article
- A New Adaptive Home-based Exercise Technology among Older Adults Living in Nursing Home: A Pilot Study on Feasibility, Acceptability and Physical Performance.The journal of nutrition, health & aging · 2017Article
- Profiling Patient Characteristics Associated With the Intensity of Nurse Care Coordination.Western journal of nursing research · 2017Article
- Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review.BMC nursing · 2017Article
- Identifying Care Coordination Interventions Provided to Community-Dwelling Older Adults Using Electronic Health Records.Computers, informatics, nursing : CIN · 2016Article
- Comparing Aging in Place to Home Health Care: Impact of Nurse Care Coordination On Utilization and Costs.Nursing economic$Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost.
designRandomized, controlled, three-arm longitudinal study.
settingParticipant homes in a large Midwestern urban area.
participantsOlder adults identified as having difficulty managing their medications at discharge from Medicare Home Health Care (N = 414).
interventionA team consisting of advanced practice nurses (APNs) and registered nurses (RNs) coordinated care for two groups: home-based nurse care coordination (NCC) plus a pill organizer group and NCC plus a medication-dispensing machine group. MEASUREMENTS: To measure cost, participant claims data from 2005 to 2011 were retrieved from Medicare Part A and B Standard Analytical Files.
resultsOrdinary least squares regression with covariate adjustment was used to estimate monthly dollar savings. Total Medicare costs were $447 per month lower in the NCC plus pill organizer group (P = .11) than in a control group that received usual care. For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC plus pill organizer group (P = .06) than in the control group. The cost of the NCC plus pill organizer intervention was $151 per month, yielding a net savings of $296 per month or $3,552 per year. The cost of the NCC plus medication-dispensing machine intervention was $251 per month, and total Medicare costs were $409 higher per month than in the NCC plus pill organizer group.
conclusionNurse care coordination plus a pill organizer is a cost-effective intervention for frail elderly Medicare beneficiaries. The addition of the medication machine did not enhance the cost effectiveness of the intervention.
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