期刊论文详细信息
BMC Family Practice
The success of behavioral economics in improving patient retention within an intensive primary care practice
Erica Levine1  Maria Duenas2  Sire Sow2  Bernard Ortega2  Nia Medder2  Ania Wajnberg2  Alexandra Capellini3  Phillip Groden3  Sandeep Kishore4 
[1] Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, Box 1199, 1216 5th Avenue, 10029, New York, NY, USA;Department of General Internal Medicine, Icahn School of Medicine at Mount Sinai, Box 1087, 1 Gustave L. Levy Place, 10029, New York, NY, USA;Icahn School of Medicine at Mount Sinai, Box 1199, 1 Gustave L. Levey Place, 10029, New York, NY, USA;School of Medicine, University of California San Francisco, 533 Parnassus Ave, 94143, San Francisco, CA, USA;
关键词: High-cost populations;    Chronic care;    Patient retention;    Behavioral economics;   
DOI  :  10.1186/s12875-021-01593-8
来源: Springer
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【 摘 要 】

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 χ2 analysis and together define patient retention.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.

【 授权许可】

CC BY   

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