COVID-19 has taken a severe toll on socioeconomically disadvantaged populations and racial and ethnic minority groups. It has disrupted traditional health care delivery and strained health systems to the breaking point. The need to address behavioral, economic, and social determinants of health—in pursuit of the triple aim of better health outcomes, improved patient experience, and reduced per capita cost—has never been so compelling.
A new study published in Health Services Research adds to the growing evidence base that community health workers (CHWs) can help meet these challenges. The study pooled data from three randomized trials to show that a standardized CHW program reduced hospitalizations and decreased fragmentation of hospital care, effects that persisted three months after the intervention ended.
CHWs are trained and trusted individuals who often share a socioeconomic background and demographic characteristics with their patients and can therefore provide support consistent with patients’ values and needs. Using participatory action research, including interviews with patients, the Penn Center for Community Health Workers developed IMPaCT (Individualized Management for Patient-Centered Targets), a standardized CHW model focused on partnering with patients to support them in meeting their individualized needs. In three prior randomized controlled trials, IMPaCT has improved a variety of health outcomes, including access to primary care, chronic disease control, and patients’ perceived quality of care.
Data from these trials demonstrate IMPaCT’s efficacy in reducing hospitalizations. Because hospitalizations account for a third of U.S. health care expenditures, reducing preventable hospitalizations is a desirable goal for all health systems working to achieve the triple aim. The takeaways are that patients who received the IMPaCT intervention had a significant and sustained reduction in hospital-based care, and decreased fragmentation of hospital-based care. The study also finds that reductions in hospitalizations began within the first 60 days of the intervention and persisted for at least three months after the intervention ended.
This story is by Aditi Vasan and John W. Morgan. Read more at Penn LDI.
