Patient Navigation for Medicaid Frequent ED Users

Not Applicable

Completed

• Conditions: Chronic Illness
• Interventions: Other: Standard of Care; Behavioral: Patient Navigator

• Registration Number: NCT01797068
• Lead Sponsor: 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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2013-02-20
• Study First Submitted QC: 2013-02-21
• Study First Posted: 2013-02-22
• Study Start: 2013-03
• Primary Completion: 2015-03
• Status Verified: 2016-11
• Last Update Submitted: 2020-03-26
• Last Update Posted: 2020-03-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 100

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)

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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.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard of Care	Standard of Care	Patients in the active comparator group will experience the usual intake process in the ED setting.
Patient Navigator	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).

Primary Outcome Measures

Name	Time	Method
Number of ED visits	One Year	Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization.

Secondary Outcome Measures

Name	Time	Method
Number of hospitalizations	One Year
Number of outpatient visits	One Year
Costs by analyzing global use with Medicaid claims data	One year

Trial Locations

Locations (1)

Yale New Haven Hospital; 🇺🇸 New Haven, Connecticut, United States