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Patient Navigation for Medicaid Frequent ED Users

Primary Purpose

Chronic Illness

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Patient Navigator
Standard of Care
Sponsored by
Yale University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Chronic Illness focused on measuring HEALTHCARE UTILIZATION, ED UTILIZATION, PRIMARY CARE UTILIZATION, PATIENT NAVIGATION, UNDERSERVED POPULATIONS, HEALTH DISPARITIES

Eligibility Criteria

18 Years - 62 Years (Adult)All SexesDoes not accept healthy volunteers

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.

Sites / Locations

  • Yale New Haven Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Patient Navigator

Standard of Care

Arm Description

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).

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

Outcomes

Primary Outcome Measures

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

Secondary Outcome Measures

Number of hospitalizations
Number of outpatient visits
Costs by analyzing global use with Medicaid claims data

Full Information

First Posted
February 20, 2013
Last Updated
March 26, 2020
Sponsor
Yale University
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1. Study Identification

Unique Protocol Identification Number
NCT01797068
Brief Title
Patient Navigation for Medicaid Frequent ED Users
Official Title
Patient Navigation to Improve Care and Reduce Costs for High Utilizers of the Emergency Department
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
March 2013 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Yale University

4. Oversight

Data Monitoring Committee
No

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Illness
Keywords
HEALTHCARE UTILIZATION, ED UTILIZATION, PRIMARY CARE UTILIZATION, PATIENT NAVIGATION, UNDERSERVED POPULATIONS, HEALTH DISPARITIES

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Patient Navigator
Arm Type
Experimental
Arm Description
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).
Arm Title
Standard of Care
Arm Type
Active Comparator
Arm Description
Patients in the active comparator group will experience the usual intake process in the ED setting.
Intervention Type
Behavioral
Intervention Name(s)
Patient Navigator
Intervention Description
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.
Intervention Type
Other
Intervention Name(s)
Standard of Care
Intervention Description
Patients in the standard of care group will experience the usual intake process in the ED setting.
Primary Outcome Measure Information:
Title
Number of ED visits
Description
Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization.
Time Frame
One Year
Secondary Outcome Measure Information:
Title
Number of hospitalizations
Time Frame
One Year
Title
Number of outpatient visits
Time Frame
One Year
Title
Costs by analyzing global use with Medicaid claims data
Time Frame
One year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
62 Years
Accepts Healthy Volunteers
No
Eligibility 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.
Facility Information:
Facility Name
Yale New Haven Hospital
City
New Haven
State/Province
Connecticut
Country
United States

12. IPD Sharing Statement

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Patient Navigation for Medicaid Frequent ED Users

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