Study protocol for a Community Health Worker (CHW)-led comprehensive neighborhood-focused program for medicaid enrollees in detroit

被引：5

作者：

Heisler, Michele ^{[1
,2
,3
]}

Lapidos, Adrienne ^{[4
]}

Henderson, James ^{[8
]}

Guzman, Rebeca M. ^{[5
]}

Wolfe, Jason ^{[6
]}

Meyer, Patricia ^{[6
]}

Law, David ^{[7
]}

Kieffer, Edith C. ^{[11
]}

Ernst, Caleb ^{[6
]}

Djelaj, Valentina ^{[5
]}

Khaldun, Joneigh ^{[5
,12
]}

Ayanian, John Z. ^{[2
,6
,9
,10
]}

机构：

[1] VA Ann Arbor Healthcare Syst, Vet Affairs Ctr Clin Management Res, 2215 Fuller Rd, Ann Arbor, MI 48105 USA

[2] Univ Michigan, Dept Internal Med, Med Sch, 1600 Plymouth Rd, Ann Arbor, MI 48109 USA

[3] Univ Michigan, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, 1415 Washington Hts,1700 SPH 1, Ann Arbor, MI 48109 USA

[4] Univ Michigan, Dept Psychiat, Med Sch, 1600 Plymouth Rd, Ann Arbor, MI 48109 USA

[5] Detroit Hlth Dept, 3245 E Jefferson,Suite 100, Jefferson, MI 48203 USA

[6] Univ Michigan, Inst Healthcare Policy & Innovat, 2800 Plymouth Rd,North Campus Res Complex,Bldg 16, Ann Arbor, MI 48109 USA

[7] Joy Southfield Community Dev Corp, 18917 Joy Rd, Detroit, MI 48228 USA

[8] Univ Michigan, Consulting Stat Comp & Analyt Res, 3550 Rackharn,915 E Washington St, Ann Arbor, MI 48109 USA

[9] Univ Michigan, Sch Publ Hlth, Dept Hlth Management & Policy, 1415 Washington Hts,1700 SPH 1, Ann Arbor, MI 48109 USA

[10] Univ Michigan, Gerald R Ford Sch Publ Policy, 735 S State St, Ann Arbor, MI 48109 USA

[11] Univ Michigan, Sch Social Work, 1080 South Univ, Ann Arbor, MI 48109 USA

[12] State Michigan Dept Hlth & Human Serv, Hartford, MI USA

来源：

CONTEMPORARY CLINICAL TRIALS COMMUNICATIONS | 2019年 / 16卷

关键词：

Community health workers; Medicaid; Detroit; Health plan utilization; Program evaluation; SOCIAL DETERMINANTS; CARE UTILIZATION; CONTROLLED-TRIAL; FOOD INSECURITY; INTERVENTIONS; DISEASE; COSTS; MANAGEMENT; IMPACT;

D O I：

10.1016/j.conctc.2019.100456

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Residents of low income neighborhoods disproportionately experience poor health, and many have unmet social needs. Clinical trials have shown the efficacy of Community Health Worker (CHW) programs in improving outcomes for a variety of health conditions. An important next step is developing and evaluating financially sustainable CHW program models in real-life settings. This program evaluation examines health care utilization among participants in a geographically targeted program led by salaried CHWs from three Medicaid health plans. Beneficiaries who reside in the Cody Rouge neighborhood of Detroit and had more than 3 Emergency Department (ED) visits or at least 1 ambulatory care-sensitive hospitalization in the prior 12 months are eligible for the program. Health plan CHWs assigned to the program reach out to eligible beneficiaries to provide an assessment; link them to resources; and provide follow-up. At 12-month follow up, claims data on ED visits, ambulatory care-sensitive hospitalizations, primary care visits, and related costs will be compared between beneficiaries who participated and eligible beneficiaries randomized to receive usual outreach. We hypothesize that patients enrolled in the CHW intervention will experience a reduction in acute care usage resulting in cost savings compared to those receiving usual health plan outreach. This study is among the first to evaluate the impact on health care utilization of augmented services delivered by health plan CHWs for high-utilizing health plan members as part of a health plan-community-academic partnership. This study will provide important information on CHW program sustainability and provide insights into effective implementation of such programs.

引用

页数：7

共 48 条

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