Your browser doesn't support javascript.
Identifying appropriate comparison groups for health system interventions in the COVID-19 era.
Savitz, Samuel T; Scott, Jason L; Leo, Michael C; Keast, Erin M; Savitz, Lucy A.
  • Savitz ST; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA.
  • Scott JL; Division of Health Care Delivery Research Mayo Clinic Rochester Minnesota USA.
  • Leo MC; Center for Health Research Kaiser Permanente Northwest Region Portland Oregon USA.
  • Keast EM; Center for Health Research Kaiser Permanente Northwest Region Portland Oregon USA.
  • Savitz LA; Center for Health Research Kaiser Permanente Northwest Region Portland Oregon USA.
Learn Health Syst ; : e10344, 2022 Sep 29.
Article in English | MEDLINE | ID: covidwho-2047827
ABSTRACT

Introduction:

COVID-19 has created additional challenges for the analysis of non-randomized interventions in health system settings. Our objective is to evaluate these challenges and identify lessons learned from the analysis of a medically tailored meals (MTM) intervention at Kaiser Permanente Northwest (KPNW) that began in April 2020.

Methods:

We identified both a historical and concurrent comparison group. The historical comparison group included patients living in the same area as the MTM recipients prior to COVID-19. The concurrent comparison group included patients admitted to contracted non-KPNW hospitals or admitted to a KPNW facility and living outside the service area for the intervention but otherwise eligible. We used two alternative propensity score methods in response to the loss of sample size with exact matching to evaluate the intervention.

Results:

We identified 452 patients who received the intervention, 3873 patients in the historical comparison group, and 5333 in the concurrent comparison group. We were able to mostly achieve balance on observable characteristics for the intervention and the two comparison groups.

Conclusions:

Lessons learned included (a) The use of two different comparison groups helped to triangulate results; (b) the meaning of utilization measures changed pre- and post-COVID-19; and (c) that balance on observable characteristics can be achieved, especially when the comparison groups are meaningfully larger than the intervention group. These findings may inform the design for future evaluations of interventions during COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Learn Health Syst Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Learn Health Syst Year: 2022 Document Type: Article