A Retrospective Cohort Study Evaluating the Association Between Implementation of a Digital Care Plan and Hospitalization Rates for Home Care Residents in the United Kingdom

Abstract

Cera, a homecare provider, uses digital care plans (DCP), to streamline the provision of home care. DCP rollout is part of a larger digitization initiative, including carer visit reports collected through a mobile app and branch actions recorded in a web application supported by a secure central database. This retrospective cohort study aimed to assess the association of a DCP rollout with service user hospitalization rates. his study utilized retrospective data from 2 groups of service users, those for whom their first 30 days of Cera membership occurred prior to DCP rollout (pre-DCP group) versus those whose first 30 days of Cera membership occurred after DCP rollout (post-DCP group). The 30-day hospitalization rate was the primary outcome measure and was determined through a combination of carer reports, reporting from service users or their families, and branch staff follow-up. There were 55 hospitalizations among 392 users in the pre-DCP group in the 30 days after joining Cera (14.0% hospitalization rate), compared to 23 hospitalizations among 297 users in the post-DCP group (7.7% hospitalization rate). This represented a significant reduction in hospitalizations in the post-DCP group (6.3% absolute difference in hospitalization rate; 45% relative reduction; P < .001). This result was robust to multiple sensitivity analyses. The implementation of a DCP was associated with a 45% relative reduction in the 30-day hospitalization rate for new service users when compared to pre-DCP enrollment. These benefits could be further amplified by combining the DCP with additional initiatives aimed at the prediction and prevention of avoidable hospitalizations.