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IMPACCT for Kids' Care (IMPACCT)

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ClinicalTrials.gov Identifier: NCT02298361
Recruitment Status : Completed
First Posted : November 21, 2014
Results First Posted : June 2, 2016
Last Update Posted : June 2, 2016
Sponsor:
Collaborator:
Oregon Health and Science University
Information provided by (Responsible Party):
Ochin, Inc.

Brief Summary:

Health insurance is important for children. Public insurance programs are available to many children, but some families report being confused about how to get and keep this insurance. Community Health Centers (CHCs) can help families get and keep health insurance for their children.

The investigators will work with families, policy makers, and community health care providers and staff to develop and test new computer health information technology (IT) tools to help health care clinics find pediatric patients in need of insurance and communicate with their families about public insurance programs. These tools will be based on technologies currently used to help patients and clinics manage chronic diseases. The investigators will test the tools by comparing four clinics using the tools and four clinics not using the tools. The investigators will look to see if children in the clinics using the tools are more likely to have health insurance and also more likely to receive certain health care services, compared to children in the clinics without such tools. The investigators will also look at health insurance rates and health care services for a larger population of Oregon children.


Condition or disease Intervention/treatment
Insurance Status/Stability Other: Health insurance outreach IT tools

Detailed Description:

Summary of protocol changes made:

  1. Changes to eligibility criteria. We changed patient eligibility to include all pediatric patients through age 19 with >=1 clinical visit in the study period. These decisions were based on: 1) at age 20, individuals are no longer eligible for children's Medicaid or CHIP in Oregon; 2) identification of PCP assignment was difficult in the EHR.
  2. Added second comparison group/study arm. In the intervention clinics, the tools were used on a smaller number of pediatric patients than anticipated, and there were significant demographic differences between intervention and control site patients, despite the clinics being matched. Thus we added a second comparison group, "within-clinic comparison patients" as pediatric patients with >=1 visit at an intervention clinic in the study period but on whom the tools were NOT used. This provided a comparison group that accounted for clinic-level effects and was more demographically similar to the "intervention patients" on whom tools were used.
  3. Revision of Aim 3 - CHIPRA recommended care assessment. We did not pursue assessment of CHIPRA quality care measures due to 1) limited follow-up time due to the need to implement iterative modifications to the study HIT tools, and 2) the tools were used on a smaller set of pediatric patients than anticipated, thus we had a very limited denominator for these analyses.

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Study Type : Observational
Actual Enrollment : 27251 participants
Time Perspective: Prospective
Official Title: Innovative Methods for Parents And Clinics to Create Tools (IMPACCT) for Kids' Care
Study Start Date : March 2013
Actual Primary Completion Date : February 2016
Actual Study Completion Date : February 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Health Insurance

Group/Cohort Intervention/treatment
Intervention patients
Community Health Centers that implemented health insurance outreach IT tools: active patients on whom tools were used
Other: Health insurance outreach IT tools
IT tools that support Community Health Centers in children's health insurance outreach efforts ("insurance outreach IT tools"), adapted from tools proven to support chronic disease management.

Within-clinic comparison patients
Community Health Centers that implemented health insurance outreach IT tools: active patients on whom tools were not used
Control clinic comparison patients
Matched Community Health Centers that did not implement health insurance outreach IT tools: active patients



Primary Outcome Measures :
  1. Percent of Study Period Covered by Medicaid [ Time Frame: 6 months pre- through 16 months post-tool implementation ]
    Percent of total days in 22-month assessment period that each child was covered by Medicaid insurance. Assessed using state administrative records linked to EHR data; this outcome was assessed among the subset of participants with a Medicaid ID (and thus could be linked between the two data sources).

  2. Proportion of Patients Who Gained Medicaid Coverage [ Time Frame: 6 months pre- through 16 months post-tool implementation ]
    Proportion of participants who gained Medicaid coverage after a period of uninsurance. Assessed using state administrative records linked to EHR data; this outcome was assessed among the subset of participants with a Medicaid ID (and thus could be linked between the two data sources) and who had partial coverage during the study period (i.e., patients with 100% coverage were not 'eligible' to gain coverage).

  3. Proportion of Patients Who Lost Medicaid Coverage [ Time Frame: 6 months pre- through 16 months post-tool implementation ]
    Proportion of participants who lost Medicaid coverage after a period of insurance. Assessed using state administrative records linked to EHR data; this outcome was assessed among the subset of participants with a Medicaid ID (and thus could be linked between the two data sources) and who had partial coverage during the study period (i.e., patients with 100% coverage were not 'eligible' to lose coverage).



Information from the National Library of Medicine

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Ages Eligible for Study:   up to 19 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
For the analysis of the primary study outcome, our study population will include all children who are "established" patients at an intervention or control clinic. Children will be considered "established" patients if they had >=1 clinical visit at a study clinic during the 18-month study period.
Criteria

Inclusion Criteria:

  • age 0-19
  • established patient (>=1 clinical visit at a study clinic in the assessment period)

Exclusion Criteria:

  • age > 19
  • not an established patient

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02298361


Sponsors and Collaborators
Ochin, Inc.
Oregon Health and Science University
Investigators
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Principal Investigator: Jennifer DeVoe, MD, DPhil OCHIN, OHSU
Study Director: Christine Nelson, RN, PhD Ochin, Inc.

Publications:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Ochin, Inc.
ClinicalTrials.gov Identifier: NCT02298361     History of Changes
Other Study ID Numbers: PCORI Award (308)
First Posted: November 21, 2014    Key Record Dates
Results First Posted: June 2, 2016
Last Update Posted: June 2, 2016
Last Verified: April 2016

Keywords provided by Ochin, Inc.:
Adolescent
Child
Child Health Services/organization & administration*
Child, Preschool
Cohort Studies
Community Health Centers/organization & administration
Community Health Centers/standards
Electronic Health Records
Feasibility Studies
Female
Health Services Accessibility/economics
Humans
Infant
Infant, Newborn
Insurance Coverage
Insurance Coverage/statistics & numerical data
Insurance Coverage/trends
Insurance, Health
Insurance, Health/legislation & jurisprudence
Insurance, Health/statistics & numerical data
Insurance, Health/trends
Logistic Models
Longitudinal Studies
Male
Medicaid
Medicaid/statistics & numerical data
Medicaid/trends
Medicaid/utilization
Medically Uninsured
Medicare/statistics & numerical data