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Improving IV Insulin Administration in a Community Hospital
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Community navigators reduce hospital utilization in super-utilizers.

Michael P Thompson1, Pradeep S B Podila, Chip Clay

  • 1University of Tennessee Health Science Center, 66 N Pauline St, Ste 608, Memphis, TN 38163.

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Community navigators significantly reduced hospital utilization for super-utilizers, a high-cost patient group. This intervention shows promise for improving healthcare efficiency and patient outcomes.

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Area of Science:

  • Health Services Research
  • Public Health
  • Healthcare Management

Background:

  • Super-utilizers represent a significant financial burden on healthcare systems due to high utilization.
  • Integrating patient navigation and community health worker roles may address complex patient needs.
  • Addressing the needs of super-utilizers is crucial for healthcare system efficiency.

Purpose of the Study:

  • To evaluate the effectiveness of community navigators in reducing hospital utilization and costs.
  • To assess the impact of community navigators on super-utilizers in a low-income urban setting.
  • To determine if a blended role of patient navigators and community health workers can improve outcomes for high-need patients.

Main Methods:

  • Controlled pre-post (difference-in-differences) study design.
  • Utilized electronic health records from 2013-2016.
  • Compared a cohort of super-utilizers (n=159) working with community navigators to a control group (n=280).

Main Results:

  • Community navigators led to an additional 13% reduction in hospital encounters and an 8% reduction in total hospital days.
  • Days between hospital encounters increased by 9% for the intervention group compared to controls.
  • Reductions in 30-day readmissions and costs were observed but did not reach statistical significance.

Conclusions:

  • Community navigators are effective in reducing subsequent hospital utilization among super-utilizers.
  • The community navigator model shows potential for improving healthcare outcomes for high-utilization patient populations.
  • Further research should explore the effectiveness of this model in diverse populations and for various outcomes.