Patient Navigation for Medicaid Frequent ED Users

NCT01797068 | Completed

• 1 other identifier: 1007007154
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

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.

Conditions

Chronic Illness

Keywords

HEALTHCARE UTILIZATION; ED UTILIZATION; PRIMARY CARE UTILIZATION; PATIENT NAVIGATION; UNDERSERVED POPULATIONS; HEALTH DISPARITIES

Outcome Measures

Primary Outcomes (1)

• Number of ED visits

  Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization.

  One Year

Secondary Outcomes (3)

• Number of hospitalizations

  One Year

• Number of outpatient visits

  One Year

• Costs by analyzing global use with Medicaid claims data

  One year

Study Arms (2)

Patient Navigator

EXPERIMENTAL

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

Standard of Care

ACTIVE COMPARATOR

Patients in the active comparator group will experience the usual intake process in the ED setting.

Other: Standard of Care

Interventions

Patient Navigator BEHAVIORAL

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.

Patient Navigator

Standard of Care OTHER

Patients in the standard of care group will experience the usual intake process in the ED setting.

Standard of Care

Eligibility Criteria

• Age: 18 Years - 62 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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)

You may not qualify if:

• 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.

Sponsors & Collaborators

• Yale University: lead

Study Sites (1)

Yale New Haven Hospital

New Haven, Connecticut, United States

Location

MeSH Terms

Conditions

Chronic Disease

Interventions

Patient Navigation; Standard of Care

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Patient-Centered Care; Primary Health Care; Comprehensive Health Care; Patient Care Management; Health Services Administration; Quality Indicators, Health Care; Quality of Health Care; Health Care Quality, Access, and Evaluation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 20, 2013
• First Posted: February 22, 2013
• Study Start: March 1, 2013
• Primary Completion: March 1, 2015
• Last Updated: March 30, 2020

Record last verified: 2016-11

Locations

US (1)