Proactive care management of AI-identified at-risk patients decreases preventable admissions

Am J Manag Care. 2024 Nov;30(11):548-554. doi: 10.37765/ajmc.2024.89625.

Abstract

Objectives: We assessed whether proactive care management for artificial intelligence (AI)-identified at-risk patients reduced preventable emergency department (ED) visits and hospital admissions (HAs).

Study design: Stepped-wedge cluster randomized design.

Methods: Adults receiving primary care at 48 UCLA Health clinics and determined to be at risk based on a homegrown AI model were included. We employed a stepped-wedge cluster randomized design, assigning groups of clinics (pods) to 1 of 4 single-cohort waves during which the proactive care intervention was implemented. The primary end points were potentially preventable HAs and ED visits; secondary end points were all HAs and ED visits. Within each wave, we used an interrupted time series and segmented regression analysis to compare utilization trends.

Results: In the pooled analysis of high-risk and highest-risk patients (n = 3007), potentially preventable HAs showed a statistically significant level drop (-27% [95% CI, -44% to -6%]), without any corresponding change in trends. Potentially preventable ED visits did not show a substantial level drop in response to the intervention, although a nonsignificant differential change in trend was observed, with visit rates decelerating 7% faster in the intervention cohorts (95% CI, -13% to 0%). Nonsignificant drops were observed for all HAs (-19% [95% CI, -35% to 1%]; P = .06) and ED visits (-15% [95% CI, -28% to 1%]; P = .06).

Conclusions: A care management intervention targeting AI-identified at-risk patients was followed by a onetime, significant, sizable reduction in preventable HA rates. Further exploration is needed to assess the potential of integrating AI and care management in preventing acute hospital encounters.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Artificial Intelligence*
  • Emergency Service, Hospital* / statistics & numerical data
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Primary Health Care
  • Risk Assessment