Evidence map›Paper›PMID 34595681›Full record

ArticleJournal of general internal medicine2021

Integrating Interprofessional Trainees into a Complex Care Program for Veterans Experiencing Homelessness: Effects on Health Services Utilization.

Lillian Gelberg, Samuel T Edwards, Elizabeth R Hooker, Meike Niederhausen, Andrew Shaner, Brianna J Cowan, Carole M Warde

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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

2 citing papers in PubMed.

  1. Article
  2. Review
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

7 authors.

Lillian GelbergDepartment of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. lgelberg@mednet.ucla.edu.
Samuel T EdwardsCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Elizabeth R HookerCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Meike NiederhausenCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
Andrew ShanerVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Brianna J CowanVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Carole M WardeVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

Funding

Optimizing Outcomes in Home-Based Primary CareIK2HX002282 · VA · PORTLAND VA MEDICAL CENTER · PI EDWARDS, SAMUEL T · 2019 to 2024
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HSRD VA IK2 HX002282
6 · The paper itself

Abstract

purposeHigh-quality, comprehensive care of vulnerable populations requires interprofessional ambulatory care teams skilled in addressing complex social, medical, and psychological needs. Training health professionals in interprofessional settings is crucial for building a competent future workforce. The impacts on care utilization of adding continuity trainees to ambulatory teams serving vulnerable populations have not been described. We aim to understand how the addition of interprofessional trainees to an ambulatory clinic caring for Veterans experiencing homelessness impacts medical and mental health services utilization.

methodsTrainees from five professions were incorporated into an interprofessional ambulatory clinic for Veterans experiencing homelessness starting in July 2016. We performed clinic-level interrupted time series (ITS) analyses of pre- and post-intervention utilization measures among patients enrolled in this training continuity clinic, compared to three similar VA homeless clinics without training programs from October 2015 to September 2018.

resultsOur sample consisted of 37,671 patient- months. There was no significant difference between the intervention and comparison groups' post-intervention slopes for numbers of primary care visits (difference in slopes =-0.16 visits/100 patients/month; 95% CI -0.40, 0.08; p=0.19), emergency department visits (difference in slopes = 0.08 visits/100 patients/month; 95% CI -0.16, 0.32; p=0.50), mental health visits (difference in slopes = -1.37 visits/month; 95% CI -2.95, 0.20; p= 0.09), and psychiatric hospitalizations (-0.005 admissions/100 patients/month; 95% CI -0.02, 0.01; p= 0.62). We found a clinically insignificant change in medical hospitalizations.

conclusionsAdding continuity trainees from five health professions to an interprofessional ambulatory clinic caring for Veterans experiencing homelessness did not adversely impact inpatient and outpatient care utilization. An organized team-based care approach is beneficial for vulnerable patients and provides a meaningful educational experience for interprofessional trainees by building health professionals' capabilities to care for vulnerable populations.

Indexed as

Ill-Housed PersonsVeteransFacilities and Services UtilizationHumansPatient Acceptance of Health CareUnited StatesUnited States Department of Veterans Affairsambulatory carehomelesshospitalizationinterprofessionalVeteran

Identifiers

PMID34595681
PMCPMC8642561

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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.