Long-Term Impact of a Postdischarge Community Health Worker Intervention on Health Care Costs in a Safety-Net System.

OBJECTIVE

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.

DATA SOURCE/SETTING

Primary and secondary data from an academic safety-net health system.

STUDY DESIGN

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.

DATA COLLECTION/EXTRACTION METHODS

We used administrative and electronic encounter data, and a survey of nurses; costs were imputed from the Medicare fee schedule.

PRINCIPAL FINDINGS

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.

CONCLUSIONS

Patient navigator interventions may be useful strategies for specific groups of patients in safety-net systems to improve transitional care while containing costs.

Abbreviation
Health Serv Res
Publication Date
2017-11-21
Volume
52
Issue
6
Page Numbers
2061-2078
Pubmed ID
29130267
Medium
Print
Full Title
Long-Term Impact of a Postdischarge Community Health Worker Intervention on Health Care Costs in a Safety-Net System.
Authors
Galbraith AA, Meyers DJ, Ross-Degnan D, Burns ME, Vialle-Valentin CE, Larochelle MR, Touw S, Zhang F, Rosenthal M, Balaban RB