How VMAP Care Navigation Supports Repeat Patients
We’re diving deeper into the data behind the VMAP Line this month! As a refresher, the VMAP Line offers free same-day consultation and care navigation for Virginia primary care, maternal health, and other healthcare professionals who treat pediatric (0-21) and perinatal patients. When a primary care clinician calls to request support for the same patient more than once, we call these repeat patients.
How Often Do We See Repeat Care Navigation Cases?
778 pediatric patients have received VMAP Line care navigation services more than once, representing roughly 9% of all care navigation patients. The data reveals that there is a median of 7 months between the first and second requests for care navigation. 33% have a 1+ year gap, 25% have a gap of 3 months or less, and 10% have a gap of 1 month or less.
This changes when we look at calls about early childhood patients, who have a median of 6 months between cases. Conversely, teens and young adults have a larger gap between cases, with a median of over 7 months. The significant time gap between cases for most repeat patients suggests a change in the patient’s mental health needs over time, rather than systemic or service failures (e.g., VMAP or the provider unable to identify appropriate resources for the patient). To further explore resource needs, we examine changes in resource categories between cases.
How Repeat Callers Utilize Different Resource Types
VMAP tracks 25 different resource types supported through care navigation services, such as counseling, psychiatry, intensive in-home services, and housing support. Nearly half of repeat patients and their families utilize multiple resource types in their first care navigation case, consistent with one-time patients.
For their second care navigation case, we examined three things:
- How often do patients have changes in their resource type needs?
- How often do patients no longer need the original resource type?
- How often do patients utilize an entirely new set of resource types?
What we found was that 82% of repeat patients have different resource needs between their first and second cases. Of these, 77% need a new type of resource, 84% no longer need the initial resource type, and 44% have an entirely different set of needs.
Looking at repeat patients who have 30 days or less between their cases, these percentages are all somewhat smaller. This indicates that patients who need new care navigation cases within a month often have the same resource needs. Still, 67% of patients have some changes in identified need categories. By contrast, when the gap between care navigation cases is a year or more, 86% of patients see a change in needs.
This change in needs, especially with a longer duration between care navigation cases, is indicative of the dynamic nature of mental healthcare for pediatric patients. It also demonstrates the ability of VMAP care navigators to provide timely and appropriate resources for patients and their families on the first encounter!
