Patient Navigation for Medicaid Frequent ED Users

Chronic Illness Clinical Trial

Official title:

Patient Navigation to Improve Care and Reduce Costs for High Utilizers of the Emergency Department

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01797068
• Other study ID #: 1007007154
• Status: Completed
• Phase: N/A
• Start date: March 2013

Study information

• Verified date: November 2016
• Source: Yale University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 100
• Est. primary completion date: March 2015
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 62 Years

Eligibility

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.

Related Conditions & MeSH terms

• Chronic Disease
• Chronic Illness

Intervention

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.

Other:
• Standard of Care
Patients in the standard of care group will experience the usual intake process in the ED setting.

Locations

Country	Name	City	State
United States	Yale New Haven Hospital	New Haven	Connecticut

Sponsors (1)

Lead Sponsor	Collaborator
Yale University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of ED visits	Additional outcomes include number of hospitalizations, number of outpatient visits, and outpatient imaging utilization.	One Year
Secondary	Number of hospitalizations		One Year
Secondary	Number of outpatient visits		One Year
Secondary	Costs by analyzing global use with Medicaid claims data		One year