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Effectiveness of Community Health Worker Intervention at Dayton Children's Hospital at Decreasing Emergency
Geoffrey Evans1,2, Shannon Franson1,3, Jessica Salem1
1Dayton Children's Hospital, OH, USA.
Insights
Community health worker interventions significantly reduced emergency department visits by 83% and hospitalizations by 77% in pediatric asthma patients. This study highlights the effectiveness of community-based asthma management programs.
Area of Science:
- Pediatric Pulmonology
- Community Health
- Healthcare Interventions
Background:
- Asthma is a chronic respiratory condition affecting millions of children.
- Emergency Department (ED) visits and hospitalizations represent significant burdens on healthcare systems and families.
- Community health workers (CHWs) can play a vital role in managing chronic diseases in pediatric populations.
Purpose of the Study:
- To evaluate the impact of asthma interventions delivered by CHWs on ED visit and hospitalization rates.
- To assess the effectiveness of a community-based asthma management program in a pediatric setting.
- To quantify the reduction in healthcare utilization for children with asthma following CHW interventions.
Main Methods:
- Retrospective analysis of patient data from 2019-2020.
- Inclusion criteria: pediatric patients with at least one ED visit, hospitalization, or PCP referral in the prior 12 months.
- Markov Chain Monte Carlo analysis with Poisson likelihood to compare pre- and post-intervention visit rates.
Main Results:
- A significant decrease in ED visits, averaging 2-4 fewer visits per patient annually (P < 1e-5).
- An 83% reduction in total ED visits for the patient population.
- A significant reduction in hospitalizations, averaging 0.1-1.5 fewer admissions per patient annually (P = .006).
- A 77% overall reduction in hospitalizations for the studied population.
Conclusions:
- CHW-led asthma interventions are highly effective in reducing ED visits and hospitalizations in children.
- Community-based asthma management programs can lead to substantial decreases in healthcare utilization.
- Implementing CHW programs can improve asthma control and reduce the burden of asthma on healthcare resources.
Objective:
To determine whether asthma interventions completed by the community health workers (CHWs) at Dayton Children's Hospital decrease the rate of Emergency Department (ED) visits and hospitalizations.
Methods:
The data was chosen from the CHW patient population that met the inclusion criteria of at least 1 hospitalization/ED visit or Primary Care Provider referral in the twelve months prior to intervention during 2019 to 2020. The visit rates from 12 months before and after intervention were analyzed with Markov Chain Monte Carlo where the likelihood was assumed to be Poisson.
Results:
The number of ED visits decreased by 2 to 4 visits (P < 1e-5) per year per patient on average. This was an 83% decrease in the number of ED visits a year for the total patient population. Hospitalization rates also saw a decrease of 0.1 to 1.5 admissions (P = .006) per year per patient. This showed an overall 77% reduction in hospitalizations for the total patient population.
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