Changes in Healthcare Utilization and Charges Among Supportive Housing Residents Enrolled in a Health Coaching Program

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dc.contributor.advisorSpence-Almaguer, Emily
dc.contributor.committeeMemberWalters, Scott T.
dc.contributor.committeeMemberStockbridge, Erica L.
dc.contributor.committeeMemberAryal, Subhash
dc.creatorChhetri, Shlesma
dc.date.accessioned2020-09-02T20:02:07Z
dc.date.available2020-09-02T20:02:07Z
dc.date.issued2019-05
dc.description.abstractThe effectiveness of self-management programs on healthcare use outcomes is an active area of research with inconsistent results. This study was the first to evaluate changes in healthcare utilization (including hospital encounters, inpatient visits, outpatient visits, and emergency visits) and charged amounts among supportive housing residents enrolled in a health coaching program. We utilized retrospective longitudinal medical claims data and a qualitative examination of participants' perceptions of the program's influence on their healthcare use. Zero-inflated negative binomial model and log-gamma models were used to assess change in count variables and charged amounts respectively. Although participants reported a positive impact of the program on their overall quality of life through improved health self-management strategies, the analysis of claims data showed no significant change in healthcare use and charged amounts in all analyses spanning 12 months prior to 24 months post enrollment. These findings may potentially demonstrate the success of health coaching programs in stabilizing healthcare utilization among individuals who otherwise might have increased their healthcare use over time. During interviews and focus groups, participants also shared personal and systems level challenges that influenced their healthcare use. The inclusion of a control group in future analyses would help measure the actual impact of health coaching on healthcare utilization measures among supportive housing residents with high health needs.
dc.format.mimetypeapplication/pdf
dc.identifier.urihttps://hdl.handle.net/20.500.12503/29854
dc.language.isoen
dc.subjectsupportive housing residents
dc.subjectchronic diseases
dc.subjecthealth coaching
dc.subjecthealthcare utilization
dc.subject.meshDelivery of Health Care
dc.subject.meshQuality of Life
dc.subject.meshPatient Acceptance of Health Care
dc.titleChanges in Healthcare Utilization and Charges Among Supportive Housing Residents Enrolled in a Health Coaching Program
dc.typeThesis
dc.type.materialtext
thesis.degree.departmentSchool of Public Health
thesis.degree.grantorUniversity of North Texas Health Science Center at Fort Worth
thesis.degree.nameDoctor of Philosophy

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