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Patient Navigation for Medicaid Frequent ED Users

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ClinicalTrials.gov Identifier: NCT01797068
Recruitment Status : Completed
First Posted : February 22, 2013
Last Update Posted : November 18, 2016
Sponsor:
Information provided by (Responsible Party):
Yale University

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.

Condition or disease Intervention/treatment Phase
Chronic Illness Behavioral: Patient Navigator Other: Standard of Care Not Applicable

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Patient Navigation to Improve Care and Reduce Costs for High Utilizers of the Emergency Department
Study Start Date : March 2013
Actual Primary Completion Date : March 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Medicaid
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Patient Navigator
Patients in the experimental group will be offered patient navigation and timely access to comprehensive care and services through Project Access-New Haven (PA-NH).
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
Patients in the active comparator group will experience the usual intake process in the ED setting.
Other: Standard of Care
Patients in the standard of care group will experience the usual intake process in the ED setting.



Primary Outcome Measures :
  1. Number of ED visits [ Time Frame: One Year ]
    Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization.


Secondary Outcome Measures :
  1. Number of hospitalizations [ Time Frame: One Year ]
  2. Number of outpatient visits [ Time Frame: One Year ]
  3. Costs by analyzing global use with Medicaid claims data [ Time Frame: One year ]


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Ages Eligible for Study:   18 Years to 62 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01797068


Locations
United States, Connecticut
Yale New Haven Hospital
New Haven, Connecticut, United States
Sponsors and Collaborators
Yale University

Responsible Party: Yale University
ClinicalTrials.gov Identifier: NCT01797068     History of Changes
Other Study ID Numbers: UL1RR024139 ( U.S. NIH Grant/Contract )
First Posted: February 22, 2013    Key Record Dates
Last Update Posted: November 18, 2016
Last Verified: November 2016

Keywords provided by Yale University:
HEALTHCARE UTILIZATION
ED UTILIZATION
PRIMARY CARE UTILIZATION
PATIENT NAVIGATION
UNDERSERVED POPULATIONS
HEALTH DISPARITIES

Additional relevant MeSH terms:
Chronic Disease
Disease Attributes
Pathologic Processes