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Impact of Community Health Workers on Use of Healthcare Services in the United States: A Systematic Review

An Evidence-Based Practice

Description

This study provided a systematic review of the impact of Community Health Worker (CHW) programs on health care use and costs. CHWs played the primary role in a health-related intervention relevant to primary care, had no professional training, were paid for their work, and were employed based on their knowledge of a community or population of interest. In 6 studies, the CHW role explicitly included connecting adults with social services such as food, housing, transportation, or insurance coverage, among other health interventions. Study periods ranged from 3 months to 3 years.

Goal / Mission

The goal of this study was to determine the effect Community Health Worker programs have on healthcare spending.

Impact

The studies show that CHW programs can help reduce emergency department visits and hospital use.

Results / Accomplishments

-3 of 7 studies reported significant reductions in ED visits compared to control groups, ranging from a 23% lower risk of any ED visit 2 years after the start of an intervention to a 51% lower annual incidence rate.

-3 of 6 studies reported significant reductions in hospital use compared to controls, ranging from a 39% lower risk of any hospitalization during a 23-month intervention to 75% fewer hospital admissions in the 6 months after compared to 6 months before an intervention.

-4 of 5 studies reported an increase in ambulatory care compared to controls, ranging from a 39% greater completion of follow-up visits to a 146% increase in ambulatory visits.

About this Promising Practice

Topics
Health / Other Conditions
For more details
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC53310...

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.
Michigan Health Improvement Alliance