This two-arm randomized controlled trial evaluated the impact of a Stepped-Care intervention (predictive analytics combined with tailored interventions) on the healthcare costs of older adults using a Personal Emergency Response System (PERS). A total of 370 patients aged 65 and over with healthcare costs in the middle segment of the cost pyramid for the fiscal year prior to their enrollment were enrolled for the study. During a 180-day intervention period, control group (CG) received standard care, while intervention group (IG) received the Stepped-Care intervention. The IG had 31% lower annualized inpatient cost per patient compared with the CG (3.7 K, $8.1 K vs. $11.8 K, p = 0.02). Both groups had similar annualized outpatient costs per patient ($6.1 K vs. $5.8 K, p = 0.10). The annualized total cost reduction per patient in the IG vs. CG was 20% (3.5 K, $17.7 K vs. $14.2 K, p = 0.04). Predictive analytics coupled with tailored interventions has great potential to reduce healthcare costs in older adults, thereby supporting population health management in home or community settings.

这项双组随机对照试验使用个人紧急响应系统 (PERS) 评估了阶梯式护理干预（预测分析与定制干预措施相结合）对老年人医疗保健成本的影响。共有 370 名 65 岁及以上的患者参加了这项研究，这些患者在入组之前的财政年度的医疗费用处于成本金字塔的中间部分。在 180 天的干预期内，对照组 (CG) 接受标准护理，而干预组 (IG) 接受阶梯式护理干预。与 CG 相比，IG 的每位患者年化住院费用降低了 31%（3.7 K，8.1 K 美元 vs. 11.8 K 美元， p = 0.02）。两组每位患者的年度门诊费用相似（6.1 K 美元 vs. 5.8 K 美元， p = 0.10）。 IG 与 CG 中每位患者的年化总成本降低了 20%（3.5 K，$17.7 K vs. $14.2 K， p = 0.04）。预测分析与量身定制的干预措施相结合，具有降低老年人医疗保健成本的巨大潜力，从而支持家庭或社区环境中的人口健康管理。