Hospitals that aim to reduce readmissions among high-risk patients may want to hire lay-health workers, according to a new study.
Researchers at the University of Kentucky piloted such a program at St. Claire Regional Medical Center, a 159-bed rural hospital in Morehead, Ky. Hospitalized adults deemed at-risk for readmission within 30 days were targeted for the intervention, according to the study published in Health Education Research.
The study team measured 30-day readmissions during a four-month baseline period, compared the data to a six-month window after the lay-health workers were deployed and found a 47.7% reduction in the readmission rate for patients who received the intervention.
Lay-health workers assisted these patients with postdischarge needs such as appointment scheduling and transportation. They were also able to serve as a resource for patients during their care journey, according to the study. Because they could offer these services—and could be deployed relatively quickly to address patients' needs—the model shows promise for high-risk patients with complex social concerns, the researchers said.
"We have the potential of impacting one's overall health if we can assist with those social determinants, such as paying bills or having access to fresh food, much more so that what we do through traditional medicine that occurs in clinics and hospitals," said the study's lead researcher, Roberto Cardarelli, D.O., chief of the division of community medicine at UK HealthCare, in an announcement.
One of the major barriers to expanding programs like the lay-health pilot is that payment structures have not quite caught up to the demand for these services, according to Cardarelli.
"Our dilemma is that our healthcare system does not pay for such services," he said, "and we continue to see marginalized populations keep coming back to hospitals in an acute crisis."
There has been increasing focus on targeting social determinants to improve health—poor minority patients, for example, face worse health outcomes than others. But while far-reaching work is necessary to address these concerns, it will require a culture shift in healthcare to fully achieve sustained population health success.
Experts have called for improved data gathering and analytics in this area to establish a stronger foundation for initiatives on the social determinants of health. Issues ranging from patient loneliness to lack of internet access are seen as areas for improvement.