Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records.
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Ingram, Maia [1] ; Doubleday, Kevin [1] ; Bell, Melanie L. [1] ; Lohr, Abby [1] ; Murrieta, Lucy [3] ; Velasco, Maria [2] ; Blackburn, John [2]
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[1] University of Arizona
University of Arizona
Estados Unidos
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[2] El Rio Community Health Center, Tucson
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[3] Sunset Community Health Center, Yuma, AZ
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- Localización: American journal of public health, ISSN 0090-0036, Vol. 107, Nº. 10, 2017, págs. 1668-1674
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
Objectives: To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs). Methods: We examined EHRs of 32 147 patients at risk for chronic disease during 2012 to 2015. Variables included contact with clinic-based CHWs, vitals, and laboratory tests. We estimated a mixed model for all outcomes. Results: Within-group findings showed statistically significant improvements in chronic disease indicators after exposure to CHWs. In health center 1, HbA1c (glycated hemoglobin) decreased 0.15 millimoles per mole (95% confidence interval [CI] = -0.24, -0.06), body mass index decreased 0.29 kilograms per meter squared (CI = -0.39, -0.20), and total cholesterol decreased 11.9 milligrams per deciliter (CI = -13.5, -10.2). In health center 2, HbA1c decreased 0.43 millimoles per mole (CI = -0.7, -0.17), body mass index decreased by 0.08 kilograms per meter squared (CI = -0.14, -0.02), and triglycerides decreased by 22.50 milligrams per deciliter (CI = -39.0, -6.0). Total cholesterol of 3.62 milligrams per deciliter (CI = -6.6, -0.6) in health center 1 was the only improvement tied to CHW contact. Conclusions: Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward. [ABSTRACT FROM AUTHOR]
