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Primary Submission Category: Interventions/Programs
Outcomes of an Asthma/COPD Community Health Worker program at a large urban safety-net hospital system
Authors: Rachel Massar, Lorraine Kwok, Joan Reibman, Alessandra Calvo-Friedman, Dawn Walter, Renata Howland, Kayla Fennelly, Yuan Jin Tan, Kasha Caesar, David Conley, John Billings, Carolyn Berry,
Presenting Author: Rachel Massar*
Asthma and COPD are chronic diseases with substantial avoidable morbidity and mortality that disproportionately affect lower socioeconomic groups and communities of color, especially in urban settings. New York City Health + Hospitals, the nation’s largest safety-net hospital system, established an Asthma/COPD Community Health Worker (CHW) program to improve care for pediatric and adult patients with uncontrolled asthma and/or COPD or those at high risk for inpatient and Emergency Department (ED) visits. CHWs help connect patients to primary and specialty care, provide education and coaching on disease self-management and medications, conduct environmental screenings via home visits, and address social needs. Program goals are to 1) prevent or reduce avoidable asthma/COPD-related inpatient or ED admissions; and 2) improve patients’ ability to manage their conditions. We are conducting a mixed-methods evaluation to assess outcomes of participation in the program. Qualitative interviews with CHWs and patients explore implementation facilitators and barriers, patient experiences, and perceived benefits. Interviews are analyzed using rapid qualitative methods. In preliminary findings, patients report high satisfaction with the program and many commented that they are better able to manage their asthma symptoms, particularly through correct use of inhalers. CHWs feel well prepared with ongoing trainings and reported some challenges including dedicated work space, availability of resources for undocumented patients and cultural/linguistic barriers. Medicaid claims and electronic health record data compare healthcare utilization and clinical outcomes among program participants (n=953) and a matched comparison group from a pool of 41,682 patients with asthma. Evaluation findings elucidate the effectiveness of CHW programs for patients struggling with asthma/COPD in an urban safety-net healthcare setting and help inform future program development and expansion.