Chronic Illness
Conditions
Keywords
HEALTHCARE UTILIZATION, ED UTILIZATION, PRIMARY CARE UTILIZATION, PATIENT NAVIGATION, UNDERSERVED POPULATIONS, HEALTH DISPARITIES
Brief summary
A large proportion of frequent ED users have Medicaid insurance. The purpose of this study is to evaluate the effectiveness of patient navigation for reducing Emergency Department (ED) visits and hospitalizations and improving patient-centered outcomes (e.g., self-reported health status, quality of life, access/barriers to care) among Medicaid patients who are high utilizers of the ED, as well as to identify best practices for engaging and providing healthcare services to underserved patients using patient navigation. This study will address needs that have been identified within the New Haven community and the local healthcare system, contribute to knowledge and literature surrounding the use of patient navigation to improve care for underserved patients and improve health system efficiency, and inform the design and development of programs that address these needs both locally and in other communities.
Interventions
BEHAVIORALPatient Navigator
Patients in the intervention group will be offered patient navigation and timely access to comprehensive care and services through Project Access-New Haven (PA-NH), a local non-profit organization that coordinates the provision of donated medical care and services to underserved patients through a network of participating hospitals and volunteer physicians.
OTHERStandard of Care
Patients in the standard of care group will experience the usual intake process in the ED setting.
Sponsors
Yale University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 62 Years
Healthy volunteers
No
Inclusion criteria
* 4-18 ED visits per year * Frequent ED users * age 18 to 62 * Medicaid insurance only * Those living in the greater New Haven area (i.e. having a zip code that matches that)
Exclusion criteria
* the current visit for primary psychiatric or substance abuse * more than 50% of all ED visits in the past year for primary psychiatric or substance abuse.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of ED visits | One Year | Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization. |
Secondary
| Measure | Time frame |
|---|---|
| Number of hospitalizations | One Year |
| Number of outpatient visits | One Year |
| Costs by analyzing global use with Medicaid claims data | One year |
Countries
United States
Outcome results
None listed