Strategies to reduce uninsured utilization of Emergency Departments (EDs) such as improved access to primary care, care coordination and management, alternative roles and functions for navigation, and emerging health information technology, cannot be fully realized independent of one another. The call for hospital systems to implement and evaluate population health management strategies as a key component of the U.S. Healthcare system’s transition to value-based care provides both the need and opportunity to research cost effective strategies for reducing preventable ED visits and hospitalizations, and associated costs among the uninsured. The Oklahoma City-County Health Department (OCCHD) Community Health Worker (CHW) Program is a small cohort pilot project implementing care coordination and management, and alternative role and functions for navigation strategies, as a partnership between local public health and non-profit hospitals.
Utilizing a pre- and post-intervention design, this study used secondary data from the program. The project captured the impact of the intervention on selected health risk indicators, ED utilization and associated self-pay charges. Data include demographic information, financial self-pay charges, and ED visit records of all study participants for a twelve-month period prior to study enrollment and for a twelve-month period following intervention. The intervention resulted in reduced volume and costs associated with uninsured utilization of EDs and preventable hospital visits. The intervention did not result in improvement of selected health risk measures including blood pressure, non-fasting glucose and BMI. This study demonstrates partnership between local non-profit hospitals and the local health department CHW program in Oklahoma County is a cost-effective strategy for reducing Emergency Department (ED) costs and preventable ED visits and hospitalizations associated with care for uninsured adults between the ages of 18 and 64.
|Advisor:||Kidd Kinney, Sharyl|
|Commitee:||Chou, Ann, Cox, Gary, Johnson, David L., Zhang, Ying|
|School:||The University of Oklahoma Health Sciences Center|
|Department:||Health Promotion Sciences|
|School Location:||United States -- Oklahoma|
|Source:||DAI-B 79/10(E), Dissertation Abstracts International|
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