Rosenman Robert, Noonan Carolyn, Muller Clemma, Maclehose Rich, Trojan Jodi, Poole Erin, Manson Spero M
The Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USA.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN, USA.
J Benefit Cost Anal. 2024 Summer;15(2):351-373. doi: 10.1017/bca.2024.24. Epub 2025 Jan 27.
Patient navigation (PN) is increasingly used to help people overcome barriers to accessing health care. In a recent trial, PN was added to motivational interviewing (MI) to help patients discharged from detoxification (detox) transition to follow-up care. The goal was to test whether PN in addition to MI increased transition rates and reduced subsequent readmissions into detox compared with MI alone. Results demonstrated little evidence of a treatment effect on either of these two outcomes, but post hoc exploratory analyses showed that patients who received PN were less likely to be arrested in the year following discharge than patients who did not receive PN. In addition, the group that received PN had fewer multiple arrests resulting in a lower average number of arrests per person. These findings are hypothesis-generating and need replication for conclusive inference. Nevertheless, economic analysis indicates that PN after detox could be a cost-beneficial intervention to reduce arrests among a population at high risk for involvement in the criminal justice system.
患者导航(PN)越来越多地被用于帮助人们克服获得医疗保健的障碍。在最近的一项试验中,将患者导航添加到动机性访谈(MI)中,以帮助戒毒后出院的患者过渡到后续护理。目标是测试与单独使用动机性访谈相比,除动机性访谈外使用患者导航是否能提高过渡率并减少随后再次进入戒毒所的情况。结果表明,几乎没有证据显示对这两个结果中的任何一个有治疗效果,但事后探索性分析表明,接受患者导航的患者在出院后一年内被捕的可能性低于未接受患者导航的患者。此外,接受患者导航的组多次被捕的情况较少,导致人均被捕平均数较低。这些发现只是初步的,需要重复验证才能得出确凿的推论。尽管如此,经济分析表明,戒毒后的患者导航可能是一种具有成本效益的干预措施,可减少有卷入刑事司法系统高风险人群的被捕情况。