Community Navigators Reduce Hospital Utilization in Super-Utilizers

Michael P. Thompson, Pradeep S.B. Podila, Chip Clay, Joy Sharp, Sandra Bailey-DeLeeuw, Armika J. Berkley, Bobby G. Baker, Teresa Waters

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Super-utilizers place a significant burden on the healthcare system. Blending the roles of patient navigators and community health workers may address the clinical and social needs of these patients. This study evaluated the effectiveness of community navigators in reducing hospital utilization and costs among super-utilizers from a low-income area in Memphis, Tennessee. STUDY DESIGN: Controlled pre-post (difference-in-differences [DID]) design using Methodist Le Bonheur Healthcare electronic health records from 2013 to 2016. METHODS: Data were abstracted for 1 year pre- and post intervention for super-utilizers working with a community navigator (n = 159) and a control group of similar super-utilizers (n = 280). We compared utilization (hospital encounters, total hospital days, days between encounters, 30-day readmissions) and costs before and after working with a navigator for the intervention group with utilization and costs in a control group not working with a navigator and compared relative changes using a DID approach. RESULTS: Utilization and cost outcomes for intervention and control groups declined significantly from the pre- to postintervention periods. Relative to the control group, super-utilizers working with community navigators had an additional 13% reduction in hospital encounters (95% CI, –19% to –6%), 8% reduction in total hospital days (95% CI, –14% to –2%), and 9% increase in days between encounters (95% CI, 4%-15%). The intervention group also had additional reductions in 30-day readmissions (–18%; 95% CI, –44% to 22%) and costs (–$4903; 95% CI, –$13,579 to $3774), but these were not statistically significant. CONCLUSIONS: Community navigators can reduce subsequent hospital utilization in super-utilizers. Expansions of this model should examine the model’s effectiveness in other populations and outcomes.

Original languageEnglish (US)
Pages (from-to)70-76
Number of pages7
JournalAmerican Journal of Managed Care
Volume24
Issue number2
StatePublished - Feb 1 2018

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Costs and Cost Analysis
Control Groups
Patient Navigation
Delivery of Health Care
Hospital Costs
Electronic Health Records
Population
U 17660
cyclo(Arg-Pro)

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Thompson, M. P., Podila, P. S. B., Clay, C., Sharp, J., Bailey-DeLeeuw, S., Berkley, A. J., ... Waters, T. (2018). Community Navigators Reduce Hospital Utilization in Super-Utilizers. American Journal of Managed Care, 24(2), 70-76.

Community Navigators Reduce Hospital Utilization in Super-Utilizers. / Thompson, Michael P.; Podila, Pradeep S.B.; Clay, Chip; Sharp, Joy; Bailey-DeLeeuw, Sandra; Berkley, Armika J.; Baker, Bobby G.; Waters, Teresa.

In: American Journal of Managed Care, Vol. 24, No. 2, 01.02.2018, p. 70-76.

Research output: Contribution to journalArticle

Thompson, MP, Podila, PSB, Clay, C, Sharp, J, Bailey-DeLeeuw, S, Berkley, AJ, Baker, BG & Waters, T 2018, 'Community Navigators Reduce Hospital Utilization in Super-Utilizers', American Journal of Managed Care, vol. 24, no. 2, pp. 70-76.
Thompson MP, Podila PSB, Clay C, Sharp J, Bailey-DeLeeuw S, Berkley AJ et al. Community Navigators Reduce Hospital Utilization in Super-Utilizers. American Journal of Managed Care. 2018 Feb 1;24(2):70-76.
Thompson, Michael P. ; Podila, Pradeep S.B. ; Clay, Chip ; Sharp, Joy ; Bailey-DeLeeuw, Sandra ; Berkley, Armika J. ; Baker, Bobby G. ; Waters, Teresa. / Community Navigators Reduce Hospital Utilization in Super-Utilizers. In: American Journal of Managed Care. 2018 ; Vol. 24, No. 2. pp. 70-76.
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abstract = "OBJECTIVES: Super-utilizers place a significant burden on the healthcare system. Blending the roles of patient navigators and community health workers may address the clinical and social needs of these patients. This study evaluated the effectiveness of community navigators in reducing hospital utilization and costs among super-utilizers from a low-income area in Memphis, Tennessee. STUDY DESIGN: Controlled pre-post (difference-in-differences [DID]) design using Methodist Le Bonheur Healthcare electronic health records from 2013 to 2016. METHODS: Data were abstracted for 1 year pre- and post intervention for super-utilizers working with a community navigator (n = 159) and a control group of similar super-utilizers (n = 280). We compared utilization (hospital encounters, total hospital days, days between encounters, 30-day readmissions) and costs before and after working with a navigator for the intervention group with utilization and costs in a control group not working with a navigator and compared relative changes using a DID approach. RESULTS: Utilization and cost outcomes for intervention and control groups declined significantly from the pre- to postintervention periods. Relative to the control group, super-utilizers working with community navigators had an additional 13{\%} reduction in hospital encounters (95{\%} CI, –19{\%} to –6{\%}), 8{\%} reduction in total hospital days (95{\%} CI, –14{\%} to –2{\%}), and 9{\%} increase in days between encounters (95{\%} CI, 4{\%}-15{\%}). The intervention group also had additional reductions in 30-day readmissions (–18{\%}; 95{\%} CI, –44{\%} to 22{\%}) and costs (–$4903; 95{\%} CI, –$13,579 to $3774), but these were not statistically significant. CONCLUSIONS: Community navigators can reduce subsequent hospital utilization in super-utilizers. Expansions of this model should examine the model’s effectiveness in other populations and outcomes.",
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