Tracy Johnson|Deborah Rinehart|Josh Durfee|Daniel Brewer|Holly Batal|Joshua Blum|Carlos Irwin A. Oronce|Paul Melinkovich|Patricia A. Gabow
For Many Patients Who Use Large Amounts Of Health Care Services, The Need Is Intense Yet Temporary
Colorado School of Public Health|Denver Public Health|University of Colorado Denver|Denver Health Medical Center|University of Colorado Denver|Denver Health Medical Center|Denver Health Medical Center|University of Colorado Denver|Denver Health Medical Center|University of Colorado Denver|Denver Health Medical Center|University of Colorado Denver|Denver Health Medical Center|University of Colorado Denver|Tulane University|Denver Health Medical Center|University of Colorado Denver|Denver Health Medical Center|University of Colorado Denver|Denver Health Medical Center|University of Colorado Denver
patients accumulate multiple emergency department visits hospital admissions known superutilizers become focus policy initiatives aimed preventing costly use health care system less expensive community primary carebased interventions conducted crosssectional longitudinal analyses 4774 publicly insured uninsured superutilizers urban safetynet integrated delivery system period may 1 2011april 30 2013 analysis found consistently 3 percent adult patients met superutilizer criteria accounted 30 percent adult charges fewer half superutilizers identified may 1 2011 remained category seven months later 28 percent remained end year finding important implications program design policy makers previous studies may obscured instability individual level study also identified clinically relevant subgroups amenable different interventions along per capita utilization costs identified superutilizers future solutions include improving predictive modeling identify individuals likely experience sustained levels avoidable utilization better classifying subgroups interventions needed implementing stronger program evaluation designs