The effectiveness of a community health worker outreach program on healthcare utilization of west Baltimore City Medicaid patients with diabetes, with or without hypertension.
OBJECTIVE
Assess impact of community health workers (CHWs) on healthcare utilization of African-American Medicaid patients with diabetes mellitus (DM) with/without hypertension (HTN).


METHODS
Maryland Medicaid claim files were analyzed to compare utilization of emergency rooms, hospitalization, and costs in a population managed by CHWs (N=117).


METHODS
Patients were recruited from the discharge rolls of the University of Maryland Medical System (UMMS) and/or the Maryland Diabetes Care Program from March 1992 to June 1994.


METHODS
CHWs alternated weekly home visits and phone contacts to teach patients to understand the need to control their illnesses, to follow both their therapy and behavioral regimens, and to maintain appropriate visits to a primary care practitioner.


RESULTS
Total emergency room (ER) visits declined by 40%; ER admissions to hospitals declined by 33%, as did total hospital admissions; and Medicaid reimbursements declined by 27%.


CONCLUSIONS
The CHW program resulted in an average savings of 2,245 dollars per patient per year, and a total savings of 262,080 dollars for 117 patients, with improved quality of life (QOL) indicating cost effectiveness.
Fedder
Donald O
DO
University of Maryland, School of Pharmacy, Baltimore, Maryland, USA. dfedder@rx.umaryland.edu
Chang
Ruyu J
RJ
Curry
Sheila
S
Nichols
Gloria
G
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D003150:Community Health Workers / Q000706:statistics & numerical data*; D003159:Community-Institutional Relations; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008875:Middle Aged; D015397:Program Evaluation; D011788:Quality of Life; D012189:Retrospective Studies