Evaluating the Impact of a Risk Assessment System With Tailored Interventions in Germany: Protocol for a Prospective Study With Matched Controls

Abstract

Background With a worldwide increase in the elderly population, and an associated increase in health care utilization and costs, preventing avoidable emergency department visits and hospitalizations is becoming a global priority. A personal emergency response system (PERS), consisting of an alarm button and a means to establish a live connection to a response center, can help the elderly live at home longer independently. Individual risk assessment through predictive modeling can help indicate what PERS subscribers are at elevated risk of hospital transport so that early intervention becomes possible. Objective The aim is to evaluate whether the combination of risk scores determined through predictive modeling and targeted interventions offered by a case manager can result in a reduction of hospital admissions and health care costs for a population of German PERS subscribers. The primary outcome of the study is the difference between the number of hospitalizations in the intervention and matched control groups. Methods As part of the Sicher Zuhause program, an intervention group of 500 PERS subscribers will be tracked for 8 months. During this period, risk scores will be determined daily by a predictive model of hospital transport, and at-risk participants may receive phone calls from a case manager who assesses the health status of the participant and recommends interventions. The health care utilization of the intervention group will be compared to a group of matched controls, retrospectively drawn from a population of PERS subscribers who receive no interventions. Results Differences in health care utilization and costs between the intervention group and the matched controls will be determined based on reimbursement records. In addition, qualitative data will be collected on the participants’ satisfaction with the Sicher Zuhause program and utilization of the interventions offered as part of the program. Conclusions The study evaluation will offer insight into whether a combination of predictive analytics and case manager-driven interventions can help in avoiding hospital admissions and health care costs for PERS subscribers in Germany living at home independently. In the future, this may lead to improved quality of life and reduced medical costs for the population of the study. Trial Registration Deutsches Register Klinischer Studien (DRKS), DRKS00017328; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017328 International Registered Report Identifier (IRRID) DERR1-10.2196/17584