The American journal of managed care
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Randomized Controlled Trial Pragmatic Clinical Trial
Scaling care coordination through digital engagement: stepped-wedge trial assessing readmissions.
Transitions of care are pivotal, vulnerable times as patients are discharged from the hospital. Telephonic care coordination is standard care, but labor intensive. We implemented a patient postdischarge digital engagement (PDDE) program to scale coordination. We hypothesized that PDDE could reduce readmissions for low-risk patients and supplement care coordination for medium- and high-risk patients. ⋯ Our study expanded resource-limited care coordination by offering low-risk patients a service they were unable to receive previously while having no impact on readmission. PDDE efficiently provided additional touch points between patients and providers.
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We examined the association between electronic health information sharing and repeat imaging in readmissions among older adults with and without Alzheimer disease (AD). ⋯ Despite substantial investment, HIEs as currently deployed and used are not associated with decreased odds of repeat imaging in readmissions.
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Counseling and education on Medicare coverage options are available through the federal State Health Insurance Assistance Program (SHIP), but little is known about the population that SHIP reaches. ⋯ These results suggest that there are areas where in-person SHIP service expansion or other additional navigation support may be warranted.
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Health inequities are frequently driven by social determinants of health (SDOH) and structural determinants of health. Our pilot sought to test the feasibility of screening for health literacy (HL) and perceived health care discrimination (PHD) through a live telephonic-facilitated survey experience with managed care patients. ⋯ It is feasible to collect self-reported HL data through a live telephonic format at the time of patient enrollment into a health plan. Health plans can leverage such screenings to better understand patient barriers for health equity-oriented interventions.
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To examine the relationship between preventive dental visits (PDVs) and medical expenditures while mitigating bias from unobserved confounding factors. ⋯ This is the first study to present estimates with causal inference from a quasi-experimental study of the effect of PDVs on overall medical expenditures. We observed that prior- or same-year PDVs were not related to overall medical or pharmacy expenditures.