Effect of Community Health Workers on 30-Day Hospital Readmission: A Meta-analysis

Despite the growing evidence that community health worker (CHW) interventions can mitigate social challenges and improve clinical outcomes in socially marginalized groups, little is known about their impact on 30-day hospital readmission rates. As such, this meta-analysis aims to evaluate the effectiveness of CHW interventions compared to usual care in reducing 30-day hospital readmission rates.

A literature search was performed using PubMed and Embase. We used a random-effects model to calculate the pooled OR with 95% confidence intervals for the impact of CHW intervention on 30-day hospital readmission rates. Heterogeneity among studies was assessed using the I² statistic, with values greater than 50% indicating moderate heterogeneity between studies. Publication bias was visually assessed using a funnel plot.

Of 235 retrieved studies, seven were eligible for inclusion, consisting of three randomized controlled trials (RCTS) and four observational studies (OBS). The pooled analysis demonstrated a significant reduction in 30-day hospital readmission rates among patients receiving CHW intervention compared to usual care (pooled log odds ratio 0.41, 95% CI = -0.74 to -0.07, p = 0.02). Subgroup analysis restricted to RCTs alone demonstrated no significant reduction in the 30-day readmission rates among patients receiving CHW interventions; however, there was a significant reduction when evaluating only OBS. Overall, this meta-analysis revealed moderate heterogeneity (I² = 63.4%), which was predominantly driven by within-group differences in RCTs (I² = 82.7%). The funnel plot's slight asymmetry suggested some potential residual heterogeneity or small-study effects.

Overall, our pooled analysis supports the effectiveness of CHW interventions in reducing 30-day hospital readmission rates for socially marginalized patients; however, we found moderate heterogeneity due to differences in study design. As such, additional research is needed to confirm these findings. If validated, CHW interventions could be essential to reducing healthcare costs for socially marginalized patient populations.