Characteristics of Hospital and Emergency Care Super-Utilizers with Multiple Chronic Conditions

Key Questions Answered
  • What were the health care utilization patterns of a group of patients identified for inclusion in a care transitions program?
  • Are patients with multiple chronic conditions and a history of hospitalizations likely to continue high utilization?
Key Themes and Takeaways

A retrospective cohort study examined the health care utilization of a group of patients in Memphis, Tennessee who met the enrollment criteria for the SafeMed Program, a care transitions program focused on reducing hospital readmissions and health care costs.

  • The program was open to adult patients with Medicaid and/or Medicare, multiple chronic conditions, and multiple hospitalizations and emergency department (ED) visits within a six-month period.
  • Researchers followed the cohort, tracking hospitalizations and ED visits in the 12 months following the six months of high health care use.
  • In the 12-month period, the cohort of patients had a mean of 3.2 hospitalizations and 2.8 ED visits without hospitalization. Although these patients had at least two chronic conditions, 46 percent said they did not have a primary care provider.
  • The study authors concluded that patients with a history of high health care utilization may continue to use expensive health care services, and may be a good target for intervention.
L. Jeff Harris
Ilana Graetz
Pradeep S.B. Podila
Jim Wan
Teresa M. Waters
James E. Bailey
Population Addressed
People with Multiple Chronic Conditions
Level of Evidence
Promising Evidence
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