Patient Navigation for Medicaid Frequent ED Users
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.
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Patient Navigation to Improve Care and Reduce Costs for High Utilizers of the Emergency Department|
- Number of ED visits [ Time Frame: One Year ] [ Designated as safety issue: No ]Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization.
- Number of hospitalizations [ Time Frame: One Year ] [ Designated as safety issue: No ]
- Number of outpatient visits [ Time Frame: One Year ] [ Designated as safety issue: No ]
- Costs by analyzing global use with Medicaid claims data [ Time Frame: One year ] [ Designated as safety issue: No ]
|Study Start Date:||March 2013|
|Estimated Primary Completion Date:||February 2015 (Final data collection date for primary outcome measure)|
|Experimental: Patient Navigator||
Behavioral: Patient 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.
|Active Comparator: Standard of Care||Other: Standard of Care|