HealthDay News — A standardized community health worker (CHW)-delivered intervention, Individual Management for Patient-Centered Targets, improves patient-perceived quality of care and reduces hospitalizations for low-income patients with chronic diseases, according to a study published online Oct. 22 in JAMA Internal Medicine.
Shreya Kangovi, M.D., from the University of Pennsylvania in Philadelphia, and colleagues recruited 592 patients from three primary care facilities in a two-armed multicenter randomized clinical trial. Patients residing in a high-poverty ZIP code who were uninsured or publicly insured and had a diagnosis of two or more chronic diseases were recruited and randomly assigned to the CHW intervention or a control arm (goal setting only).
The researchers found similar improvements in self-rated physical health in the two arms (mean, 1.8 versus 1.6; P = 0.89). Intervention group patients had an increased likelihood of reporting the highest quality of care (odds ratio, 1.8; 95 percent confidence interval, 1.4 to 2.4; P < 0.001) and spent fewer total days in the hospital at six and nine months (absolute event rate reduction, 69 and 65 percent, respectively). The odds of repeat hospitalizations were lower for patients in the intervention group (odds ratio, 0.4; 95 percent confidence interval, 0.2 to 0.9).
“It’s remarkable that these results were achieved not by an expensive drug or technology but from good old-fashioned social support,” Kangovi said in a statement.