What is the impact of introducing a non-clinical community health advice and navigation service on the demand for primary care in socially deprived areas? Evidence from an observational panel study with difference-in-differences design

Wild, Eva-Maria; Winter, Vera; Ress, Vanessa; Golubinski, Veronika

doi:10.1136/bmjopen-2022-061964

Cited by 3 publications

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In one intervention in England, community health workers supported primary health care teams in a deprived urban area by addressing primarily social problems; this was associated with a reduction in the number of GP consultations and generally more appropriate use of primary care services (Abbott and Davidson, 2000). An earlier study of the same non‐clinical community health advice and navigation service examined in the present investigation found that this easily accessible first point of contact might improve access to the health system, reduce unmet care needs and increase demand (Wild et al., 2022). In this separate study, which aimed to assess the effect of the integrated care initiative on the demand for GP visits, the role of the cross‐sector network of providers was not considered.…”

Section: Literature Reviewmentioning

confidence: 77%

The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework

Ress,

Wild

2023

Health Economics

View full text Add to dashboard Cite

We investigated the impact of an integrated care initiative in a socially deprived urban area in Germany. Using administrative data, we empirically assessed the causal effect of its two sub‐interventions, which differed by the extent to which their instruments targeted the supply and demand side of healthcare provision. We addressed confounding using propensity score matching via the Super Learner machine learning algorithm. For our baseline model, we used a two‐way fixed‐effects difference‐in‐differences approach to identify causal effects. We then employed difference‐in‐differences analyses within an event‐study framework to explore the heterogeneity of treatment effects over time, allowing us to disentangle the effects of the sub‐interventions and improve causal interpretation and generalizability. The initiative led to a significant increase in hospital and emergency admissions and non‐hospital outpatient visits, as well as inpatient, non‐hospital outpatient, and total costs. Increased utilization may indicate that the intervention improved access to care or identified unmet need.

show abstract

Section: Literature Reviewmentioning

confidence: 77%

The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework

Ress,

Wild

2023

Health Economics

View full text Add to dashboard Cite

show abstract

Codesigning a Community Health Navigator program to assist patients to transition from hospital to community

Harris,

Tran,

Porwal

et al. 2024

Aust. J. Prim. Health

View full text Add to dashboard Cite

Background This study aimed to identify the potential roles for Community Health Navigators (CHNs) in addressing problems faced by patients on discharge from hospital to the community, and attitudes and factors which may influence their adoption. Methods Twenty-six qualitative interviews and an online codesign workshop were conducted with patients, nurses, general practice staff, health service managers, community health workers, general practitioners, medical specialists, and pharmacists in the Sydney Local Health District. Qualitative themes from the interviews and workshop transcripts were analysed inductively and subsequently grouped according to a socio-ecological model. Results CHNs could assist patients to navigate non-clinical problems experienced by patients on discharge through assessing needs, establishing trust, providing social and emotional support that is culturally and linguistically appropriate, engaging family and carers, supporting medication adherence, and helping to arrange and attend follow up health and other appointments. Important factors for the success of the CHNs in the performance and sustainability of their roles were the need to establish effective communication and trust with other healthcare team members, be accepted by patients, have access to information about referral and support services, receive formal recognition of their training and experience, and be supported by appropriate supervision. Conclusions This study was unique in exploring the potential role of CHNs in addressing problems faced by patients on discharge from Australian hospitals and the factors influencing their adoption. It informed training and supervision needs and further research to evaluate CHNs’ effectiveness and the acceptance of their role within the healthcare team.

show abstract

Social disparities in access and quality of consultation in outpatient care in Germany

von dem Knesebeck,

Lüdecke,

Klein

2024

BMC Prim. Care

View full text Add to dashboard Cite

Background Overall, research on social determinants of access and quality of outpatient care in Germany is scarce. Therefore, social disparities (according to sex, age, income, migration background, and health insurance) in perceived access and quality of consultation in outpatient care (primary care physicians and specialists) in Germany were explored in this study. Methods Analyses made use of a cross-sectional online survey. An adult population sample was randomly drawn from a panel which was recruited offline (N = 2,201). Perceived access was assessed by waiting time for an appointment (in days) and travel time to the practice (in minutes), while quality of consultation was measured by consultation time (in minutes) and quality of communication (scale of four items, Cronbach’s Alpha 0.89). Results In terms of primary care, perceived access and quality of consultation was worse among women compared to men. Estimated consultation time was shorter among people with statutory health insurance compared to privately insured respondents. Regarding specialist care, people aged 60 years and older reported shorter waiting times and better quality of communication. Lower income groups reported lower quality of communication, while perceived access and quality of consultation was worse among respondents with a statutory health insurance. Variances explained by the social characteristics ranged between 1% and 4% for perceived access and between 3% and 7% for quality of consultation. Conclusion We found social disparities in perceived access and quality of consultation in outpatient care in Germany. Such disparities in access may indicate structural discrimination, while disparities in quality of consultation may point to interpersonal discrimination in health care.

show abstract

What is the impact of introducing a non-clinical community health advice and navigation service on the demand for primary care in socially deprived areas? Evidence from an observational panel study with difference-in-differences design

Cited by 3 publications

References 27 publications

The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework

The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework

Codesigning a Community Health Navigator program to assist patients to transition from hospital to community

Social disparities in access and quality of consultation in outpatient care in Germany

Contact Info

Product

Resources

About