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- Title
Long-Term Impact of a Postdischarge Community Health Worker Intervention on Health Care Costs in a Safety-Net System.
- Authors
Galbraith, Alison A.; Meyers, David J.; Ross‐Degnan, Dennis; Burns, Marguerite E.; Vialle‐Valentin, Catherine E.; Larochelle, Marc R.; Touw, Sharon; Zhang, Fang; Rosenthal, Meredith; Balaban, Richard B.; Ross-Degnan, Dennis; Vialle-Valentin, Catherine E
- Abstract
<bold>Objective: </bold>Patient navigators (PNs) may represent a cost-effective strategy to improve transitional care and reduce hospital readmissions. We evaluated the impact of a PN intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system.<bold>Data Source/setting: </bold>Primary and secondary data from an academic safety-net health system.<bold>Study Design: </bold>We compared per-patient utilization and costs, overall and by age, for high-risk, medical service patients randomized to the PN intervention relative to usual care between October 2011 and April 2013. Intervention patients received hospital visits and telephone outreach from PNs for 30 days after every qualifying discharge.<bold>Data Collection/extraction Methods: </bold>We used administrative and electronic encounter data, and a survey of nurses; costs were imputed from the Medicare fee schedule.<bold>Principal Findings: </bold>Total costs per patient over the 180 days postindex discharge for those aged ≥60 years were significantly lower for PN patients compared to controls ($5,676 vs. $7,640, p = .03); differences for patients aged <60 ($9,942 vs. $9,046, p = .58) or for the entire cohort ($7,092 vs. $7,953, p = .27) were not significant.<bold>Conclusions: </bold>Patient navigator interventions may be useful strategies for specific groups of patients in safety-net systems to improve transitional care while containing costs.
- Subjects
MEDICAL personnel; MEDICAL care costs; PATIENT readmissions; MEDICAL care; MEDICAL care surveys; HEART failure treatment; OBSTRUCTIVE lung disease treatment; OBSTRUCTIVE lung diseases; AGE distribution; COMPARATIVE studies; CONTINUUM of care; HEART failure; LENGTH of stay in hospitals; RESEARCH methodology; MEDICAL cooperation; PATIENT satisfaction; RESEARCH; RESEARCH funding; STATISTICAL sampling; SOCIOECONOMIC factors; EVALUATION research; RANDOMIZED controlled trials; DISCHARGE planning; PATIENT-centered care; SAFETY-net health care providers; ECONOMICS
- Publication
Health Services Research, 2017, Vol 52, Issue 6, p2061
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12790