Evidence map›Paper›PMID 37233831›Full record

ArticleAdministration and policy in mental health2023

Can a Home-Based Collaborative Care Model Reduce Health Services Utilization for Older Medicaid Beneficiaries Living with Depression and Co-occurring Chronic Conditions? A Quasi-experimental Study.

Lesley Steinman, Jingping Xing, Beverly Court, Norma B Coe, Andrea Yip, Clara Hill, Bea Rector, Barbara Baquero, Bryan J Weiner, Mark Snowden

Abstract read
In one paragraph

Article in Administration and policy in mental health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

10 authors.

Lesley SteinmanHealth Promotion Research Center, Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, USA. lesles@uw.edu.ORCID 0000-0002-2098-5105
Jingping XingResearch and Data Analysis Division, Washington State Department of Social and Health Services, Olympia, USA.
Beverly CourtResearch and Data Analysis Division, Washington State Department of Social and Health Services, Olympia, USA.
Norma B CoeMedical Ethics and Health Policy, University of Pennsylvania, Philadelphia, USA.ORCID 0000-0003-1228-0938
Andrea YipSeattle-King County Aging and Disability Services, Seattle, USA.
Clara HillDepartment of Human Development, Washington State University, Pullman, USA.
Bea RectorWashington State Department of Social and Health Services, Aging and Long-Term Support Administration, Lacey, USA.
Barbara BaqueroHealth Promotion Research Center, Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, USA.
Bryan J WeinerDepartment of Global Health, University of Washington Schools of Medicine and Public Health, Seattle, USA.
Mark SnowdenDepartment of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA.

Funding

Scientific/Technical CoreP2CHD042828 · NICHD · UNIVERSITY OF WASHINGTON · PI SARA R. CURRAN · 2017 to 2026
$6.3M
NICHD NIH HHS P2C HD042828
6 · The paper itself

Abstract

Depression remains a major public health issue for older adults, increasing risk of costly health services utilization. While home-based collaborative care models (CCM) like PEARLS have been shown to effectively treat depression in low-income older adults living with multiple chronic conditions, their economic impact is unclear. We conducted a quasi-experimental study to estimate PEARLS effect on health service utilization among low-income older adults. Our secondary data analysis merged de-identified PEARLS program data (N = 1106), home and community-based services (HCBS) administrative data (N = 16,096), and Medicaid claims and encounters data (N = 164) from 2011 to 2016 in Washington State. We used nearest neighbor propensity matching to create a comparison group of social service recipients similar to PEARLS participants on key determinants of utilization guided by Andersen's Model. Primary outcomes were inpatient hospitalizations, emergency room (ER) visits, and nursing home days; secondary outcomes were long-term supports and services (LTSS), mortality, depression and health. We used an event study difference-in-difference (DID) approach to compare outcomes. Our final dataset included 164 older adults (74% female, 39% people of color, mean PHQ-9 12.2). One-year post-enrollment, PEARLS participants had statistically significant improvements in inpatient hospitalizations (69 fewer hospitalizations per 1000 member months, p = 0.02) and 37 fewer nursing home days (p < 0.01) than comparison group participants; there were no significant improvements in ER visits. PEARLS participants also experienced lower mortality. This study shows the potential value of home-based CCM for participants, organizations and policymakers. Future research is needed to examine potential cost savings.

Indexed as

Home Care ServicesMedicaidAgedChronic DiseaseDepressionFacilities and Services UtilizationFemaleHumansMaleUnited StatesDepressionDifference-in-differenceHome and community-based servicesOlder adultsPovertyPropensity matching

Identifiers

PMID37233831
PMCPMC11753177

What OpenQuestion holds

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Registered trials

None linked

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.