Patient-centered interventions by community health workers improved the post-hospital care of patients of low socioeconomic status, including improving access to primary care follow-up appointments and reducing readmission rates, according to a study in JAMA Internal Medicine.
Community health workers worked with patients during their hospital stays to develop individualized action plans for each patient's recovery goals. Community health workers provided follow-up support for at least two weeks after patients were discharged.
Researchers found 60 percent of patients who received support from community health workers received "timely" primary care after discharge, compared to 47.9 percent of patients in the control group.
Intervention patients were also more likely to report high-quality discharge communication than non-intervention patients, at 91.3 percent and 78.7 percent, respectively.
Additionally, intervention patients showed greater improvements in mental health and patient activation.
Patients in both arms of the study experienced similar 30-day readmission rates, but only 2.3 percent of intervention patients experienced multiple readmissions, compared to 5.5 percent of nonintervention patients.
Researchers suggest hospitals take advantage of community health workers who address behavioral and socioeconomic barriers to care to improve post-hospital outcomes.
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