Health Care Utilization
Conditions
Brief summary
Using data from the Chelsea Eats program, we propose to study a randomized controlled trial in which the City of Chelsea, Massachusetts held a lottery to allocate cash benefits to its residents for ten months during the first two years of the COVID-19 pandemic. We will analyze the impact of the cash benefit on health care utilization and health.
Interventions
OTHERCash Benefit
Spending from the cards was not restricted to food but could be spent on anything and anywhere Visa was accepted. The debit cards were credited with the first payment on November 18th, 2020 and the second payment on December 18th, 2020. The program continued with monthly credits through August 2021.
OTHERNo Cash Benefit
No monthly cash benefit.
Sponsors
Brigham and Women's Hospital
Cambridge Health Alliance
Harvard Medical School (HMS and HSDM)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Resident of Chelsea, Massachusetts * Household income at or below 30% of the U.S. Department of Housing and Urban Development's Area Median Income
Exclusion criteria
* See inclusion criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emergency department use | 10 months | Count of visits to the emergency department (ED) using the electronic health record |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Substance use disorder-related ED visit | 10 months | Visits to the ED with a substance use disorder-related diagnosis code |
| Potentially avoidable ED visit | 10 months | Visits to the ED that are potentially avoidable, categorized as avoidable according to the previously validated New York University algorithm |
| ED visit resulting in admission to the hospital | 10 months | Visits to the ED that result in a hospitalization |
| Outpatient service use | 10 months | Office visits and visits for other types of outpatient care such as imaging and procedures |
| Behavioral health-related ED visit | 10 months | Visits to the ED with a behavioral health-related diagnosis code |
| Hemoglobin A1c | 10 months | Continuous measure of diabetes, using the latest available reading or result during trial period |
| Blood pressure | 10 months | Continuous measure of blood pressure, using the latest available reading or result during trial period |
| Weight | 10 months | Continuous measure of weight, using the latest available reading or result during trial period |
| Cholesterol | 10 months | Continuous measure of cholesterol, using the latest available reading or result during trial period |
| COVID vaccination | 10 months | Binary variable for having received at least one dose of any COVID vaccine by the end of the trial period |
Countries
United States
Outcome results
None listed