Evidence map›Paper›PMID 25617166›Full record

Trial reportJournal of general internal medicine2015

A Patient Navigator Intervention to Reduce Hospital Readmissions among High-Risk Safety-Net Patients: A Randomized Controlled Trial.

Richard B Balaban, Alison A Galbraith, Marguerite E Burns, Catherine E Vialle-Valentin, Marc R Larochelle, Dennis Ross-Degnan

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05527392 (Assessing the Effect of Virtual Navigation Interventions to Improve Health Insurance Literacy and Decrease Financial Burden), which is not on this map. Cited by 73 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
73citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05527392 naactive not recruitingnot on this mapstarted 2023, after this paper: background citation

Assessing the Effect of Virtual Navigation Interventions to Improve Health Insurance Literacy and Decrease Financial Burden: A Childhood Cancer Survivor Study Randomized Trial (HINTII)

TypeinterventionalSponsorMassachusetts General HospitalRan2023 to 2027Enrolled529ConditionsChildhood Cancer SurvivorsArmsHealth Insurance Navigation Tools Program
3 · Its place in the literature

Who cites it

73 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  4. Patient- and family-centred care transition interventions for adults: a systematic review and meta-analysis of RCTs.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2023
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13 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Richard B BalabanCambridge Health Alliance, Harvard Medical School, Somerville Hospital Primary Care, 236 Highland Ave., Somerville, MA, 02143, USA, rbalaban@challiance.org.
Alison A Galbraith
Marguerite E Burns
Catherine E Vialle-Valentin
Marc R Larochelle
Dennis Ross-Degnan

Funding

Evaluating Sequential Strategies to Reduce Readmission in a Diverse PopulationR01HS020628 · AHRQ · HARVARD PILGRIM HEALTH CARE, INC. · PI ROSS-DEGNAN, DENNIS · 2012 to 2014
$1.4M
AHRQ HHS 1R01HS020628-01A1AHRQ HHS R01 HS020628
6 · The paper itself

Abstract

backgroundEvidence-based interventions to reduce hospital readmissions may not generalize to resource-constrained safety-net hospitals.

objectiveTo determine if an intervention by patient navigators (PNs), hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients.

designRandomized controlled trial.

participantsGeneral medicine inpatients having at least one of the following readmission risk factors: (1) age ≥60 years, (2) any in-network inpatient admission within the past 6 months, (3) length of stay ≥3 days, (4) admission diagnosis of heart failure, or (5) chronic obstructive pulmonary disease. The analytic sample included 585 intervention patients and 925 controls.

interventionsPNs provided coaching and assistance in navigating the transition from hospital to home through hospital visits and weekly telephone outreach, supporting patients for 30 days post-discharge with discharge preparation, medication management, scheduling of follow-up appointments, communication with primary care, and symptom management. MAIN MEASURES: The primary outcome was in-network 30-day hospital readmissions. Secondary outcomes included rates of outpatient follow-up. We evaluated outcomes for the entire cohort and stratified by patient age >60 years (425 intervention/584 controls) and ≤60 years (160 intervention/341 controls). KEY

resultsOverall, 30-day readmission rates did not differ between intervention and control patients. However, the two age groups demonstrated marked differences. Intervention patients >60 years showed a statistically significant adjusted absolute 4.1% decrease [95% CI: -8.0%, -0.2%] in readmission with an increase in 30-day outpatient follow-up. Intervention patients ≤60 years showed a statistically significant adjusted absolute 11.8% increase [95% CI: 4.4%, 19.0%] in readmission with no change in 30-day outpatient follow-up.

conclusionsA patient navigator intervention among high risk, safety-net patients decreased readmission among older patients while increasing readmissions among younger patients. Care transition strategies should be evaluated among diverse populations, and younger high risk patients may require novel strategies.

Indexed as

AdultAgedAged, 80 and overAge FactorsCommunity Health WorkersContinuity of Patient CareDelivery of Health CareFemaleHealth Services ResearchHumansMaleMassachusettsMiddle AgedOutcome Assessment, Health CarePatient NavigationPatient Readmission

Identifiers

PMID25617166
PMCPMC4471016

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.