• Am J Manag Care · Feb 2022

    Intersection of complexity and high utilization among health center patients aged 18 to 64 years.

    • Nadereh Pourat, Xiao Chen, Yusuke Tsugawa, Connie Lu, Weihao Zhou, Hank Hoang, Brionna Hair, Joshua Bolton, and Alex Sripipatana.
    • UCLA Center for Health Policy Research, 10960 Wilshire Blvd, Ste 1550, Los Angeles, CA 90024. Email: pourat@ucla.edu.
    • Am J Manag Care. 2022 Feb 1; 28 (2): 66-72.

    ObjectivesExisting literature indicates that multimorbidity, mental health (MH) conditions, substance use disorders (SUDs), and social determinants of health are hallmarks of high-need, high-cost patients. Health Resources and Services Administration-funded health centers (HCs) provide care to nearly 30 million patients, but data on their patients' complexity and utilization patterns are limited. We identified subgroups of HC patients based on latent concepts of complexity and utilization.Study DesignWe used cross-sectional national data from the 2014 Health Center Patient Survey and latent class analyses to identify distinct and homogenous groups of complex high-utilizing patients aged 18 to 64 years.MethodsWe included indicators of chronic conditions (CCs), MH, SUD risk, and health behavior to measure complexity. We used number of outpatient and emergency department visits in the past year to measure utilization.ResultsHC patients were separated in 9 distinct groups based on 3 complexity latent classes (MH, multiple CCs, and low risk) and 3 utilization classes (low, high, and superutilizers). Conditions associated with each subgroup differed. The highest prevalence of bipolar disorder (45%) and high SUD risk (6%) was observed among MH superutilizers, whereas the highest prevalence of cardiovascular disease (48%) and obesity (96%) was seen among CC superutilizers. Most MH superutilizer patients concurrently had MH conditions and obesity and were smokers, but most CC superutilizer patients concurrently had hypertension, obesity, and cardiovascular disease.ConclusionsOur examination of complexity and utilization indicated distinct HC patient populations. Managing the care of each group may require different targeted intervention approaches such as multidisciplinary care teams that include MH providers or specialists.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…