Evidence Bank

The Evidence Bank is a collection of research studies on common services provided by CBOs that demonstrate outcomes attractive to a health care partner. This collection is updated on a bimonthly basis. For more information, read our Explanations and Instructions page.

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Care Transitions October 26, 2004 Care Transitions Program Objectives To test whether an intervention designed to encourage older patients and their caregivers to assert a more active role during care transitions can reduce re-hospitalization rates. Design Quasi-experimental design whereby subjects receiving the intervention (n=158) were com... Read More
Care Transitions June 13, 2014 Transitions in Care Program ABSTRACT Conducted between July 2011 through September 2013 at Barnabas Health in Northern New Jersey. All patients age 65 and older who came into medical center’s emergency department or were admitted to the hospital were screened for dementia, frailty, and chronic conditions. Staff e... Read More
Care Management/Care Coordination April 25, 2016 The Ambulatory Integration of the Medical and Social Model Abstract  An exploratory, retrospective evaluation of Ambulatory Integration of the Medical and Social (AIMS), a care coordination model designed to integrate medical and non-medical needs of patients and delivered exclusively by social workers was conducted to examine mean utilization... Read More
Care Management/Care Coordination, Interdisciplinary Team Care March 14, 2011 Guided Care Background The effect of interdisciplinary primary care teams on the use of health services by patients with multiple chronic conditions is uncertain. This study aimed to measure the effect of guided care teams on multi-morbid older patients\' use of health services. Methods Eligible... Read More
Care Management/Care Coordination April 1, 2014 The Individualized Management for Patient-Centered Targets (IMPaCT) Importance  Socioeconomic and behavioral factors can negatively influence post-hospital outcomes among patients of low socioeconomic status (SES). Traditional hospital personnel often lack the time, skills, and community linkages required to address these factors. Objective To determ... Read More
Care Management/Care Coordination November 2, 2018 The Johns Hopkins Community Health Partnership (J-CHiP) Importance  The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland. Objective To determine whether the Johns Hopkins Community Health Partnership (J-CHiP) was associated with improved outcomes and lower... Read More
Mental Health December 17, 2014 Beat the Blues Objectives To test the cost-effectiveness of a home-based depression program, Beat the Blues (BTB). Design We conducted a cost-effectiveness analysis as part of a previously reported randomized controlled trial that tested BTB versus a wait-list control group. Setting Community-dwe... Read More