scholarly journals Cost-Effective Care Coordination for People With Dementia at Home

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Amber Willink ◽  
Karen Davis ◽  
Deirdre M Johnston ◽  
Betty Black ◽  
Melissa Reuland ◽  
...  
Keyword(s):  
Community Health ◽  
Care Coordination ◽  
Care Management ◽  
Comparison Group ◽  
Health Workers ◽  
Cost Effective ◽  
People With Dementia ◽  
Home Intervention ◽  
Matched Comparison ◽  
At Home

Abstract Background and Objectives People with dementia (PWD) represent some of the highest-need and highest-cost individuals living in the community. Maximizing Independence (MIND) at Home is a potentially cost-effective and scalable home-based dementia care coordination program that uses trained, nonclinical community workers as the primary contact between the PWD and their care partner, supported by a multidisciplinary clinical team with expertise in dementia care. Research Design and Methods Cost of care management services based on actual time spent by care management personnel over first 12 months of MIND at Home intervention was calculated for 342 MIND at Home recipients from Baltimore, Maryland and surrounding areas participating in a Centers for Medicare and Medicaid Services (CMS) funded Health Care Innovation Award demonstration project. Difference-in-differences analysis of claims-based Medicaid spending of 120 dually-eligible MIND at Home participants with their propensity score matched comparison group (n = 360). Results The average cost per enrollee per month was $110, or $1,320 per annum. Medicaid expenditures of dually-eligible participants grew 1.12 percentage points per quarter more slowly than that of the matched comparison group. Most savings came from slower growth in inpatient and long-term nursing home use. Net of the cost of the 5-year MIND at Home intervention, 5-year Medicaid savings are estimated at $7,052 per beneficiary, a 1.12-fold return on investment. Discussion and Implications Managed care plans with the flexibility to engage community health workers could benefit from a low-cost, high-touch intervention to meet the needs of enrollees with dementia. Limitations for using and reimbursing community health workers exist in Medicare fee-for-service, which CMS should address to maximize benefit for PWD.

Community Health Workers (CHWs) as Innovators

2018 ◽  
Vol 13 (1) ◽  
pp. 15-28
Author(s):  
Tyler Prentiss ◽  
John Zervos ◽  
Mohan Tanniru ◽  
Joseph Tan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Underserved Populations ◽  
Low Cost ◽  
Cost Effective ◽  
Well Being ◽  
Grant Writing ◽  
Multiple Sources ◽  
Context Of Learning

Community health workers (CHWs) have a longstanding role in improving the health and well-being of underserved populations in resource-limited settings. CHWs are trusted in the communities they serve and are often able to see through solutions on community challenges that outside persons cannot. Notwithstanding, such solutions often must be low-cost, easily implementable, and permit knowledge gaps among CHWs to be filled via appropriate training. In this sense, use of cost-effective information technology (IT) solutions can be key to increasing access to knowledge for these community agents. This paper highlights insights gleaned from a pilot study performed in Detroit, Michigan with a group of CHWs in basic grant-writing training via an e-platform, the Community Health Innovator Program (CHIP). The results are discussed within the context of learning theory. It is concluded that e-platforms are necessary for CHWs to leverage knowledge from multiple sources in an adaptive environment towards addressing ever-evolving global health challenges.

scholarly journals Effectiveness of service models and organisational structures supporting tuberculosis identification and management in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e019642 ◽  
Author(s):  
Charlotte C Heuvelings ◽  
Patrick F Greve ◽  
Sophia G de Vries ◽  
Benjamin Jelle Visser ◽  
Sabine Bélard ◽  
...  
Keyword(s):  
Systematic Review ◽  
European Union ◽  
Cost Effectiveness ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Cost Effective ◽  
Service Models ◽  
Hard To Reach Populations ◽  
Organisational Structures

ObjectiveTo determine which service models and organisational structures are effective and cost-effective for delivering tuberculosis (TB) services to hard-to-reach populations.DesignEmbase and MEDLINE (1990–2017) were searched in order to update and extend the 2011 systematic review commissioned by National Institute for Health and Care Excellence (NICE), discussing interventions targeting service models and organisational structures for the identification and management of TB in hard-to-reach populations. The NICE and Cochrane Collaboration standards were followed.SettingEuropean Union, European Economic Area, European Union candidate countries and Organisation for Economic Co-operation and Development countries.ParticipantsHard-to-reach populations, including migrants, homeless people, drug users, prisoners, sex workers, people living with HIV and children within vulnerable and hard-to-reach populations.Primary and secondary outcome measuresEffectiveness and cost-effectiveness of the interventions.ResultsFrom the 19 720 citations found, five new studies were identified, in addition to the six discussed in the NICE review. Community health workers from the same migrant community, street teams and peers improved TB screening uptake by providing health education, promoting TB screening and organising contact tracing. Mobile TB clinics, specialised TB clinics and improved cooperation between healthcare services can be effective at identifying and treating active TB cases and are likely to be cost-effective. No difference in treatment outcome was detected when directly observed therapy was delivered at a health clinic or at a convenient location in the community.ConclusionsAlthough evidence is limited due to the lack of high-quality studies, interventions using peers and community health workers, mobile TB services, specialised TB clinics and improved cooperation between health services can be effective to control TB in hard-to-reach populations. Future studies should evaluate the (cost-)effectiveness of interventions on TB identification and management in hard-to-reach populations and countries should be urged to publish the outcomes of their TB control systems.PROSPERO registration numberCRD42015017865.

scholarly journals Home Intervention For Mother And Premature Infant: A Literature Review

2021 ◽  
Author(s):  
Rinik Kapti ◽  
Moses Pandin
Keyword(s):  
Health Education ◽  
Health Workers ◽  
Quality Care ◽  
Premature Baby ◽  
Health Issues ◽  
Premature Babies ◽  
Home Intervention ◽  
Article Analysis ◽  
At Home

Abstract Background: Premature babies have a greater risk for having health issues after being discharged from the hospital whilst the mother ability to provide premature baby care still has many issues as well. Interventions are needed to be given to mothers at home to improve the ability of mothers to care their premature babies. Methods: Search for articles used the bolean operator of “or” and “and” with the keywords used were “preterm or premature”, “intervention or program”, and “mother and home”. Data based used were Sciencedirect, Ebscohost, PubMed, SAGE, Proquest and Scopus with inclusion criteria using full text in English from 2018 to 2021. There were 428 articles obtained, the articles were then screened by reading the main focus of articles with paying attention to the topic and the suitability of article content and we obtained 13 suitable articles. Results: The interventions at home carried out for mothers and premature babies were divided into two namely the follow-up interventions from the hospital and the interventions carried out at the patient's home. Seven articles about research of interventions that were as a combination from hospital intervention with follow-up hospital intervention plus five full interventions at the patient's home. Interventions were provided through home visits (12 articles) and by telephone (1 article). The results of the article analysis resulted in 4 main themes of intervention for mothers and premature babies, they were health education, counceling, support, and care for premature babies. Conclusion: Quality care is essential for the best health, growth and development of premature babies. Interventions need to be carried out by health workers to ensure the readiness and ability of mothers to care for their babies. Maternal readiness and abilities can be improved by providing health education, counseling, support and care for premature babies.

An enriched medical home intervention using community health workers improves adherence to immunization schedules

Vaccine ◽  
2015 ◽  
Vol 33 (46) ◽  
pp. 6257-6263 ◽  
Author(s):  
Susmita Pati ◽  
Kristi L. Ladowski ◽  
Angie T. Wong ◽  
Jiayu Huang ◽  
Jie Yang
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Medical Home ◽  
Health Workers ◽  
Home Intervention

scholarly journals Community Health Workers as an Extension of Care Coordination in Primary Care

2018 ◽  
Vol 41 (4) ◽  
pp. 333-340 ◽  
Author(s):  
Jean M. Gunderson ◽  
Mark L. Wieland ◽  
Onelis Quirindongo-Cedeno ◽  
Gladys B. Asiedu ◽  
Jennifer L. Ridgeway ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Community Health Workers ◽  
Care Coordination ◽  
Health Workers

scholarly journals Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization

2019 ◽  
Vol 14 (8) ◽  
pp. 818-825 ◽  
Author(s):  
Michael Brainin ◽  
Valery Feigin ◽  
Philip M Bath ◽  
Epifania Collantes ◽  
Sheila Martins ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Community Health ◽  
Community Health Workers ◽  
Stroke Prevention ◽  
Health Workers ◽  
Cost Effective ◽  
Lifestyle Changes ◽  
Prevention Strategy ◽  
Lipid Lowering ◽  
Prevention Strategies

The increasing burden of stroke and dementia emphasizes the need for new, well-tolerated and cost-effective primary prevention strategies that can reduce the risks of stroke and dementia worldwide, and specifically in low- and middle-income countries (LMICs).  This paper outlines conceptual frameworks of three primary stroke prevention strategies: (a) the “polypill” strategy; (b) a “population-wide” strategy; and (c) a “motivational population-wide” strategy.  (a) A polypill containing generic low-dose ingredients of blood pressure and lipid-lowering medications (e.g. candesartan 16 mg, amlodipine 2.5 mg, and rosuvastatin 10 mg) seems a safe and cost-effective approach for primary prevention of stroke and dementia.  (b) A population-wide strategy reducing cardiovascular risk factors in the whole population, regardless of the level of risk is the most effective primary prevention strategy. A motivational population-wide strategy for the modification of health behaviors (e.g. smoking, diet, physical activity) should be based on the principles of cognitive behavioral therapy. Mobile technologies, such as smartphones, offer an ideal interface for behavioral interventions (e.g. Stroke Riskometer app) even in LMICs.  (c) Community health workers can improve the maintenance of lifestyle changes as well as the adherence to medication, especially in resource poor areas. An adequate training of community health workers is a key point. Conclusion An effective primary stroke prevention strategy on a global scale should integrate pharmacological (polypill) and lifestyle modifications (motivational population-wide strategy) interventions. Side effects of such an integrative approach are expected to be minimal and the benefits among individuals at low-to-moderate risk of stroke could be significant. In the future, pragmatic field trials will provide more evidence.

Are community health workers cost-effective for childhood vaccination in India?

Vaccine ◽  
2019 ◽  
Vol 37 (22) ◽  
pp. 2942-2951 ◽  
Author(s):  
Deepti Bettampadi ◽  
Matthew L. Boulton ◽  
Laura E. Power ◽  
David W. Hutton
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Cost Effective ◽  
Childhood Vaccination

scholarly journals Barriers and Facilitators of Engaging Community Health Workers in Non-Communicable Disease (NCD) Prevention and Control in China: A Systematic Review (2006–2016)

2018 ◽  
Vol 15 (11) ◽  
pp. 2378 ◽  
Author(s):  
Hongfei Long ◽  
Wenting Huang ◽  
Pinpin Zheng ◽  
Jiang Li ◽  
Sha Tao ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Communicable Disease ◽  
Cost Effective ◽  
Barriers And Facilitators ◽  
Community Based Interventions ◽  
Cost Effective Approach ◽  
Dominant Disease ◽  
Implementation Effect

Background: Non-communicable diseases (NCDs) have become a dominant disease burden in China. Although China has a prevention-centered NCD strategy, the implementation effect in the community has been subjected to manpower and financial difficulties. Engaging community health workers (CHWs) in community-based interventions may be a cost-effective approach to relieve the resource shortage and improve health. This review aimed to synthesize evidence on types of NCD-related care that was provided by CHWs in China, and to identify relevant barriers and facilitators. Methods: A literature search was conducted in Medline, PubMed, ProQuest, and Google Scholar databases for English-written, peer-reviewed articles published from 1996 to 2016 that reported findings from NCD-related interventions delivered by CHWs in China. Each article was extracted independently by two researchers. Results: Twenty distinct studies met the inclusion criteria. The two most common types of CHW-led NCD-related care were diabetes and hypertension management (n = 7) and mental health care (n = 7). Thirteen studies discussed the barriers and 16 studies reported facilitators. The most common barriers included lack of support (n = 6), lack of resources (n = 4), and heavy reliance on technology (n = 4). The common facilitators included an integrated health system (n = 9), community and patient trust (n = 5), high quality training (n = 5), and CHWs’ capacity (n = 5). Fourteen studies mentioned training content, while only eight described detailed procedures and duration. Conclusions: This review suggests that trained and supervised Chinese CHWs had the capacity to provide grassroots NCDs preventive interventions. In order to increase the generalizability and sustainability of such programs, studies with robust designs are needed to explore the effectiveness of CHW-led programs, and the intervention strategies to improve the practice of CHWs in various settings.

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