Evidence map›Paper›PMID 34937551›Full record

Trial reportBMC family practice2021

The success of behavioral economics in improving patient retention within an intensive primary care practice.

Phillip Groden, Alexandra Capellini, Erica Levine, Ania Wajnberg, Maria Duenas, Sire Sow, Bernard Ortega, Nia Medder, Sandeep Kishore

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 8% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Phillip GrodenIcahn School of Medicine at Mount Sinai, 1 Gustave L. Levey Place, Box 1199, New York, NY, 10029, USA. phillip.groden@mountsinai.org.ORCID 0000-0003-1712-482X
Alexandra CapelliniIcahn School of Medicine at Mount Sinai, 1 Gustave L. Levey Place, Box 1199, New York, NY, 10029, USA.
Erica LevineArnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, 1216 5th Avenue, Box 1199, New York, NY, 10029, USA.
Ania WajnbergDepartment of General Internal Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
Maria DuenasDepartment of General Internal Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
Sire SowDepartment of General Internal Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
Bernard OrtegaDepartment of General Internal Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
Nia MedderDepartment of General Internal Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
Sandeep KishoreSchool of Medicine, University of California San Francisco, 533 Parnassus Ave, San Francisco, CA, 94143, USA.
Icahn School of Medicine at Mount Sinai · USUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA minority of the U.S. population comprises a majority of health care expenses. Health system interventions for high-cost populations aim to improve patient outcomes while reducing costly over-utilization. Missed and inconsistent appointments are associated with poor patient outcomes and increased health care utilization. PEAK Health- Mount Sinai's intensive primary care clinic for high-cost patients- employed a novel behavioral economics-based intervention to reduce the rate of missed appointments at the practice. Behavioral economics has accomplished numerous successes across the health care field; the effect of a clinic-based behavioral economics intervention on reducing missed appointments has yet to be assessed.

methodsThis was a single-arm, pre-post trial conducted over 1 year involving all active patients at PEAK Health. The intervention consisted of: a) clinic signage, and b) appointment reminder cards containing behavioral economics messaging designed to increase the likelihood patients would complete their subsequent visit; appointment cards (t1) were transitioned to an identical EMR template (t2) at 6 months to boost provider utilization. The primary objective, the success of scheduled appointments, was assessed with visit adherence: the proportion of successful over all scheduled appointments, excluding those cancelled or rescheduled. The secondary objective, the consistency of appointments, was assessed with a 2-month visit constancy rate: the percentage of patients with at least one successful visit every 2 months for 1 year. Both metrics were assessed via a χ

resultsThe visit adherence rate increased from 74.7% at baseline to 76.5% (p = .22) during t1 and 78.0% (p = .03) during t2. The 2-month visit constancy rate increased from 59.5% at baseline to 74.3% (p = .01) post-intervention.

conclusionsA low-resource, clinic-based behavioral economics intervention was capable of improving patient retention within a traditionally high-cost population. A renewed focus on patient retention- employing the metrics described here- could bolster chronic care efforts and significantly improve the outcomes of high-cost programs by reducing the deleterious effects of missed and inconsistent appointments.

Indexed as

Appointments and SchedulesEconomics, BehavioralAmbulatory Care FacilitiesHumansPatient CompliancePrimary Health CareReminder SystemsBehavioral economicsChronic careHigh-cost populationsPatient retention

Identifiers

PMID34937551
PMCPMC8694759
OpenAlexW4225829954

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.