A decade ago, Dr. Jeff Brenner started working with hospitals in Camden, a city with high poverty and crime rates, to identify people who go to hospitals frequently and target them with special services. He won a MacArthur genius grant for the work, and federal grants expanded the program to Aurora, Colorado; Kansas City, Missouri; Allentown, Pennsylvania; and San Diego. The government also paid for a study to see if it truly worked.
Half were given usual care when they left the hospital. The rest were enrolled in Brenner’s program with nurses, social workers and others coordinating their care for three months. Patients received seven to eight home visits and nine phone calls on average. The effort cost about $5,000 per patient. Researchers don’t know what usual care was for the comparison group. If that suddenly improved, it could explain why the program failed to prove better.
“If you’re in a shelter or on the streets, it’s just not easy to help and that sometimes leads to more hospitalizations,” said the Camden project’s leader, Kathleen Noonan.help for mental health“We’ve evolved a lot” since the program began, said Brenner, who now is an executive working on similar programs at the insurance company UnitedHealthcare.