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

Abstract

A PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. Our findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time periods.

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

“…As in prior studies from this trial (Balaban et al. , ), we found a differential impact of the PN intervention based on patient age. Our prior studies found lower 30‐day readmission rates and 180‐day hospital‐based utilization rates for PN patients aged 60 or older, but higher rates among those under age 60 (Balaban et al.…”

“…Our prior studies found lower 30‐day readmission rates and 180‐day hospital‐based utilization rates for PN patients aged 60 or older, but higher rates among those under age 60 (Balaban et al. , ). The lower costs among older PN patients versus controls may be due in part to the trend toward lower rates of ED visits and hospitalizations or may reflect lower cost per encounter if PN services mitigate some health issues or facilitate patients to return to care when they require less intensive services and shorter lengths of stay (Thompson, Roebuck, and Stewart ; Bryant‐Lukosius et al.…”

“…As in our previous studies (Balaban et al. , ), we stratified all analyses by age group (<60 and ≥60 years). In the first study (Balaban et al.…”

“…We examine the impact on costs for subgroups defined by age, given that our prior studies of this CHW intervention found reductions in 30‐day readmissions and 180‐day hospital‐based utilization for older patients but higher rates in younger patients (Balaban et al. , ).…”

Capsule Commentary on Balaban et al., Impact of a Patient Navigator Program on Hospital-Based and Outpatient Utilization Over 180 Days in a Safety-Net Health System

“…Specifically, the most effective programs seem to involve close, interpersonal interaction among care coordinators, patients, and primary care clinicians; a focus on care transitions; a component of medication management; and the targeting of patients amenable to intervention, such as the frail elderly. 2 The study by Balaban et al 3 in this week's JGIM adds important insights to this burgeoning literature.…”