QUALITY IMPROVEMENT
Care coordination for patients with chronic conditions did not reduce hospital admissions or Medicare costs
| The first 150 words of the full text of this article appear below. |
STUDY DESIGN
15 randomised controlled trials (Medicare Coordinated Care Demonstration). ClinicalTrials.gov NCT00627029 [ClinicalTrials.gov] .
concealed.*
unblinded.*
STUDY QUESTION
15 various healthcare settings in the USA.
18 402 patients (181–2657 patients per programme) covered by fee-for-service Medicare (78% aged 65–84 y; 55% women) who had 
1 chronic condition (eg, coronary artery disease 61%, heart failure 48%, diabetes 39%, and chronic obstructive pulmonary disease 32%). Each programme defined its own target population.
9427 patients were assigned to care coordination (each programme designed its own intervention) and 8975 to usual care. Although the interventions differed, most involved a care coordinator assigned to each patient who assessed patient needs, developed patient care plans, educated patients to improve adherence, and improved care coordination.
hospital admissions, Medicare expenditures (including negotiated programme fees of mean $235/member per mo but not including prescriptions drugs), and quality-of-care measures. A p value <0.10 was considered statistically significant.
1–4 years (mean 30 mo).
100% (intention-to-treat analysis).
MAIN RESULTS
Queen's Hospital, Burton-on-Trent, UK
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