The Impact of Patient Complexity on Healthcare Utilization and Health

The Impact of Patient Complexity on Healthcare Utilization and Health

Lead Principal Investigator: Abby Sears, MBA, MHA

Organization:  OCHIN

Purpose:  To examine the impact of patient clinical and social complexity on utilization of care and the effect that has on quality of care measures for health systems.

Funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (R-1603-34987).

The Impact of Patient Complexity on Healthcare Utilization and Health

Lead Principal Investigator: Abby Sears, MBA, MHA

Organization:  OCHIN

Purpose:  To examine the impact of patient clinical and social complexity on utilization of care and the effect that has on quality of care measures for health systems.

Funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (R-1603-34987).

Overview

doc

Engaged 14 clinicians/health systems leaders groups and 3 patient groups (total of 71 individuals) to learn which community-level factors and performance metrics are considered most important
Finalized the list of social determinants of health and quality of care measures to analyze
Developed and finalized Phase 2 Engagement Plan to share the preliminary data findings and for stakeholder input on data interpretation

who's involved?

sites

2 participating Networks:
ADVANCE, OneFlorida
Advisory Team: composed of one health systems leader, one clinician, and one patient from each CDRN, as well as subject matter experts on social determinants of health data and comorbidity risk data

hospital

Health Systems Leaders, Clinicians, and Patients:
1) prioritize the social determinants of health domains, as well as the preventive and quality of care measures, and 2) assist with data interpretation

how we're making a difference

patients

Use of community-level social determinants of health to evaluate patient social complexity from the Common Data Mode (CDM)
Use of validated comorbidity assessments (Charlson Comorbidity Index) to evaluate patient clinical complexity from the CDM
Use of matched data from Oregon and Florida Medicaid claims data, which allows the opportunity to determine the relative contribution of clinical and social complexity to prioritized quality of care measures