Identifying High-Cost, High-Need Patients in a Network of Community Hospitals

Gabriel Zdrale, Alison Essary, Stephan Bremer, Wesley Peng, Weiqi Chen, Edward Kalpas

Research output: Contribution to journalArticlepeer-review

Abstract

We examined healthcare costs at HonorHealth, a community-based academic health center comprised of 5 hospitals and numerous ambulatory care facilities. Patient encounters that resulted in admission in 2019 were included in the study. Mean costs in 2019 for high costs and high needs (HCHN) patients were compared with all remaining patients using a framework developed by the National Academy of Medicine. HCHN patients were older (71 vs 52 years), with a lower percentage of females (41.7% vs 59.8%), more frequently White (90.1% vs 87.5%), less frequently married (52.4% vs 54.5%), with a longer length of stay (6.5 vs 3.0 days) and higher mean charges ($134 743 vs $16 414). The mean cost per patient in the HCHN group decreased by age group ($192, 963, $165 200, $144 584, $134 795, and $108 356) for 0 to 18, 19 to 44, 45 to 64, 65 to 84, and 85+ years, respectively. HCHN patients were more publicly insured (49% vs 38%). Targeted interventions to treat HCHN may lead to lower healthcare costs and improved health outcomes within this system.

Original languageEnglish (US)
JournalJournal of Primary Care and Community Health
Volume15
DOIs
StatePublished - Jan 1 2024

Keywords

  • access to care
  • complex medical needs
  • high cost
  • high need
  • social determinants

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health

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