Evidence map›Paper›PMID 29162073›Full record

ArticleBMC health services research2017

Patient navigation to improve diabetes outpatient care at a safety-net hospital: a retrospective cohort study.

Michal Horný, Wiljeana Glover, Gouri Gupte, Aruna Saraswat, Varsha Vimalananda, James Rosenzweig

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Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  16. How Do Hospitals Organize Diabetes Services? A Comparative Study.International journal of preventive medicine · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michal HornýDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Woodruff Memorial Research Building, Room 1215A, 101 Woodruff Circle, Atlanta, GA, 30322, USA. michal.horny@emory.edu.ORCID http://orcid.org/0000-0003-3624-6398
Wiljeana GloverDepartment of Technology, Operations, and Information Management, Babson College, 231 Forest Street, Babson Park, MA, 02457, USA.
Gouri GupteDepartment of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA.
Aruna SaraswatTufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Varsha VimalanandaDepartment of Medicine, Boston University School of Medicine, 715 Albany St, Boston, MA, 02118, USA.
James RosenzweigDepartment of Medicine, Boston University School of Medicine, 715 Albany St, Boston, MA, 02118, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent emphasis on value based care and population management, such as Accountable Care Organizations in the United States, promote patient navigation to improve the quality of care and reduce costs. Evidence supporting the efficacy of patient navigation for chronic disease care is limited. The objective of this study was to evaluate the effect of a patient navigation program on medical and administrative outcomes among patients with diabetes in an urban, safety-net hospital clinic setting.

methodsA retrospective cohort study with pre- and post-intervention periods was conducted. Eligible patients were those with A1C ≥ 8.5% and at least one appointment no-show in the previous 12 months. The intervention and reference groups were balanced on observed characteristics and baseline outcome levels using propensity score matching. The effect of patient navigation was isolated using the difference-in-differences approach. Primary outcomes were A1C, low-density lipoprotein cholesterol, triglycerides, random urine microalbumin, the number of scheduled appointments, clinic visits, emergency visits, and inpatient stays, and the percentage of arrivals, cancellations, and no-shows to scheduled appointments.

resultsOf 797 eligible patients, 328 entered the navigation program. Matching reduced the sample size to 392 individuals (196 in each group). Patient navigation resulted in improved A1C (-1.1 percentage points; p < .001), more scheduled appointments (+ 5.3 per year; p < .001), more clinic visits (+6.4 per year; p < .001), more arrivals to scheduled appointments (+7.4 percentage points; p = .009) and fewer no-shows (-9.8 percentage points; p < .001).

conclusionsNavigation was associated with improved glycemic control and better clinic engagement among patients with diabetes. Further research is important to identify what features of navigation in diabetes care are critical to achieving success and to understand navigators' role in other settings.

Indexed as

Patient NavigationAdultAgedAmbulatory CareAppointments and SchedulesBostonChronic DiseaseDiabetes MellitusFemaleGlycated HemoglobinHospitalizationHospitals, UrbanHumansMaleMiddle AgedOutcome Assessment, Health CareGlycated HemoglobinDiabetes managementPatient-centered medical homePatient navigation

Identifiers

PMID29162073
PMCPMC5699176

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LicenceCC BY
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Registered trials

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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.