International Journal of Clinical Trials
Vol. 11, Issue 1
Date of Publication:
January 2024
Background: Estonia’s aging population faces an increasing burden of non-communicable diseases (NCDs) and a growing population suffers with multiple chronic conditions. These changes have reduced well-being and quality of life for many older Estonians, while increasing the use of high cost specialist and emergency care. In response, the Estonia Health Insurance Fund (EHIF) is working to support primary care physicians to improve care for complex patients with multiple chronic conditions. A new EHIF program, Enhanced Care Management (ECM), trains family physicians to identify complex patients, co-develop proactive care plans with them, and conduct more active outreach and management of these patients.
Methods: In this protocol we describe a randomized controlled trial, developed in partnership with EHIF, to evaluate the impact of ECM training for physicians. The RCT enrolled a randomly selected 97 family physicians out of the 786 family physicians practicing in Estonia. Among those physicians’ 6,739 ECM-eligible patients, 2,389 patients were randomly selected for enrolment into the ECM program.
Results: Using administrative records, we evaluated the effects of ECM enrolment on: (1) health care utilization; (2) provider management of tracer conditions; and (3) markers of quality of care such as hospital admission for primary health care-sensitive conditions.
Conclusions: This protocol presents a pre-specified analysis plan for this evaluation of Estonia’s ECM program.
Citations
Daniels, Benjamin, Daniel Rogger, Meyhar Mohammed, Katre Vaarsi and Kevin Croke. 2024. Evaluation of Estonia’s enhanced care management program: protocol for a cluster randomized trial. International Journal of Clinical Trials 11, no. 1 (January).