Community health workers and medicaid managed care in New Mexico.
Community health workers and medicaid managed care in New Mexico.
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DOI：
10.1007/s10900-011-9484-1
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发表时间：
2012-06
影响因子：
5.9
通讯作者：
Kaufman, Arthur
中科院分区：
文献类型：
--
作者：
Johnson, Diane;Saavedra, Patricia;Sun, Eugene;Stageman, Ann;Grovet, Dodie;Alfero, Charles;Maynes, Carmen;Skipper, Betty;Powell, Wayne;Kaufman, Arthur
我们描述了社区卫生工作者(CHW)向医疗补助管理保健系统中卫生资源的高消费者登记人员提供基于社区的支持服务的影响。我们对新墨西哥州33个县中11个县的448名参与者进行了回溯性研究，他们被分配到实地社区卫生服务机构。CHW为患者提供长达6个月的教育、宣传和社会支持。收集了有关所提供的服务和获取社区资源的数据。分别在干预前6个月、干预中6个月和干预后6个月收集急诊科、住院服务、非麻醉药品和麻醉药品处方以及门诊初级护理和专科护理的利用和付款。为了进行比较，收集了另一组448名参与者的数据，他们也是卫生资源的高消费者，但没有接受CHW干预。就所有指标而言，在社区卫生工作者干预后，索赔和付款的数量都有显著减少。在所有指标上，非CHW组的费用也有所下降，但降幅较小，比CHW组使用门诊服务的降幅更大。将实地社区卫生工作者作为医疗补助管理保健的一部分，为高资源消耗的登记人提供支持性服务，可以改善获得预防和社会服务的机会，并可能减少资源利用和成本。
We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico’s 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost.
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DOI：
10.1177/0884217502239215
发表时间：
2002-11-01
影响因子：
1.8
作者：
Gilliland, AL
通讯作者：
Gilliland, AL
影响因子：
1.4
作者：
Whitley, EM;Everhart, RM;Wright, RA
通讯作者：
Wright, RA
影响因子：
12.7
作者：
Krieger, J;Collier, C;Martin, D
通讯作者：
Martin, D
影响因子：
5.9
作者：
Lacey, L;Tukes, S;Warnecke, R B
通讯作者：
Warnecke, R B
影响因子：
3
作者：
Ware, JE;Kosinski, M;Keller, SD
通讯作者：
Keller, SD