Evidence map›Paper›PMID 31914242›Full record

Trial reportThe New England journal of medicine2020

Health Care Hotspotting - A Randomized, Controlled Trial.

Amy Finkelstein, Annetta Zhou, Sarah Taubman, Joseph Doyle

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 161 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
161citing papers in PubMed, 7 pooled it
34.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02090426 nacompletednot on this map

Health Care Hotspotting: A Randomized Controlled Trial

TypeinterventionalSponsorAbdul Latif Jameel Poverty Action LabRan2014 to 2020Enrolled800ConditionsHigh Utilizers of Hospital CareArmsLink2Care
NCT07587073 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Pragmatic Cluster-Randomized Evaluation of Enhanced Care Management With Community Supports, Transitional Care, and Residential Care Coordination for High-Risk Medi-Cal Members Under CalAIM in California

TypeinterventionalSponsorStratiHealthRan2026 to 2028Enrolled1,200ConditionsComplex Care, Post-Acute Care Utilization, Housing Instability, Residential Care TransitionArmsComprehensive CalAIM Care Bundle, Usual CalAIM Service Delivery
3 · Its place in the literature

Who cites it

161 citing papers in PubMed, 7 syntheses or guidelines pooled it, 309 citations in OpenAlex.

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  6. Discharge planning from hospital.The Cochrane database of systematic reviews · 2022
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101 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Amy FinkelsteinFrom the Massachusetts Institute of Technology (A.F., J.D.) and the National Bureau of Economic Research (A.Z., S.T.) - both in Cambridge.
Annetta ZhouFrom the Massachusetts Institute of Technology (A.F., J.D.) and the National Bureau of Economic Research (A.Z., S.T.) - both in Cambridge.
Sarah TaubmanFrom the Massachusetts Institute of Technology (A.F., J.D.) and the National Bureau of Economic Research (A.Z., S.T.) - both in Cambridge.
Joseph DoyleFrom the Massachusetts Institute of Technology (A.F., J.D.) and the National Bureau of Economic Research (A.Z., S.T.) - both in Cambridge.
Massachusetts Institute of Technology · USNational Bureau of Economic Research · US

Funding

A Randomized Controlled Trial of Health Care HotspottingR01AG049897 · NIA · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI FINKELSTEIN, AMY N. · 2015 to 2019
$2.7M
NIA NIH HHS 5R01AG049897-02NIA NIH HHS R01 AG049897
6 · The paper itself

Abstract

backgroundThere is widespread interest in programs aiming to reduce spending and improve health care quality among "superutilizers," patients with very high use of health care services. The "hotspotting" program created by the Camden Coalition of Healthcare Providers (hereafter, the Coalition) has received national attention as a promising superutilizer intervention and has been expanded to cities around the country. In the months after hospital discharge, a team of nurses, social workers, and community health workers visits enrolled patients to coordinate outpatient care and link them with social services.

methodsWe randomly assigned 800 hospitalized patients with medically and socially complex conditions, all with at least one additional hospitalization in the preceding 6 months, to the Coalition's care-transition program or to usual care. The primary outcome was hospital readmission within 180 days after discharge.

resultsThe 180-day readmission rate was 62.3% in the intervention group and 61.7% in the control group. The adjusted between-group difference was not significant (0.82 percentage points; 95% confidence interval, -5.97 to 7.61). In contrast, a comparison of the intervention-group admissions during the 6 months before and after enrollment misleadingly suggested a 38-percentage-point decline in admissions related to the intervention because the comparison did not account for the similar decline in the control group.

conclusionsIn this randomized, controlled trial involving patients with very high use of health care services, readmission rates were not lower among patients randomly assigned to the Coalition's program than among those who received usual care. (Funded by the National Institute on Aging and others; ClinicalTrials.gov number, NCT02090426; American Economic Association registry number, AEARCTR-0000329.).

Indexed as

AdultAgedAmbulatory CareChronic DiseaseHealth Care CostsHospitalizationHouse CallsHumansLinear ModelsMiddle AgedNew JerseyPatient Care ManagementPatient Discharge SummariesPatient ReadmissionProspective StudiesSocioeconomic Factors

Identifiers

PMID31914242
PMCPMC7046127
OpenAlexW3000450122

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.