Impact of a Patient Navigator Program on Hospital-Based and Outpatient Utilization Over 180 Days in a Safety-Net Health System

Journal of General Internal Medicine
Richard B BalabanDennis Ross-Degnan

Abstract

With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. Randomized controlled trial conducted October 2011 through April 2013. Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease. The analytic sample included 739 intervention patients, 1182 controls. Through hospital visits and 30 days of post-discharge telephone outreach, PNs provided coaching and assistance with medications, appointments, transportation, communication with primary care, and self-care. Primary outcomes: (1) hospital-based utilization, a composite of ED visits and hospital admissions; (2) hospital admissions; (3) ED visits; and (4) outpatient visits. We evaluated outcomes following an index discharge, stratified by patient age (≥ 60 and < 60 years), using a 180-day time frame divided into six 30-day...Continue Reading

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Citations

Jan 9, 2019·The Cochrane Database of Systematic Reviews·Andrea TakedaStephanie Jc Taylor
Apr 26, 2019·JBI Database of Systematic Reviews and Implementation Reports·Amy E ReidAmanda Rose Horsman
Apr 2, 2020·American Journal of Lifestyle Medicine·Gary A SforzoMargaret Moore
May 31, 2019·Journal of General Internal Medicine·David T LissChristine Schaeffer
Jan 9, 2020·Journal of Healthcare Management / American College of Healthcare Executives·Taylor J HorynaCharles F Seifert
Aug 2, 2019·International Journal of Integrated Care·Ann E M LiljasJanne Agerholm
Aug 28, 2019·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Richard BalabanBenjamin Le Cook
Sep 4, 2020·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Sarah E WakemanJoshua P Metlay
Sep 9, 2021·The Cochrane Database of Systematic Reviews·Charlotte C PootPersijn J Honkoop
Sep 12, 2021·BMC Health Services Research·Laurent Perrault-SequeiraMark Goldszmidt

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