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Effects of a Standardized Community Health Worker Intervention on Health Care Utilization Within an Integrated
Aditi Vasan1,2,3, Molly Knowles4,5, Shaun Flerchinger6,7
1Division of General Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. vasana@chop.edu.
Journal of General Internal Medicine
|April 11, 2025
Summary
Community health worker (CHW) interventions reduced hospital days and increased primary care visits for low-income patients. This standardized approach, Individualized Management for Patient Centered Targets (IMPaCT), shows promise in integrated health systems.
Area of Science:
- Public Health
- Health Services Research
- Health Equity
Background:
- Community health worker (CHW) interventions are known to improve health outcomes and reduce acute care use.
- Limited research exists on CHW interventions' impact within integrated health systems.
Purpose of the Study:
- To evaluate the Individualized Management for Patient Centered Targets (IMPaCT) CHW intervention.
- Assess IMPaCT's effect on acute care utilization and primary care engagement in low-income patients within an integrated health system.
Main Methods:
- Prospective randomized analysis with adjusted difference-in-differences regression.
- 1230 adults in low-income zip codes randomized to IMPaCT (n=820) or usual care (n=410).
- IMPaCT involved 3 months of weekly remote coaching, support, and navigation tailored to patient goals.
Main Results:
- IMPaCT patients had a significant reduction in hospital days (-172.3 days per 1000 members/month, p=0.022).
- A higher proportion of IMPaCT patients attended primary care visits (85.7% vs. 79.5%, p=0.006).
- No significant difference in emergency department utilization was observed between groups.
Conclusions:
- Remote delivery of a standardized CHW intervention (IMPaCT) reduced hospital utilization.
- The intervention improved primary care engagement among low-income patients in an integrated health system during the COVID-19 pandemic.
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