Dataset Information

Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs.

ABSTRACT:

Objective

To understand how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older adults.

Study setting

Sixteen Hospital Service Areas (HSAs) in the United States.

Study design

We conducted a qualitative study of HSAs with performance in the top or bottom quartiles nationally across three key outcomes: ambulatory care sensitive hospitalizations, all-cause risk-standardized readmission rates, and average reimbursements per Medicare beneficiary. We selected 10 higher performing HSAs and six lower performing HSAs for inclusion in the study.

Data collection

To understand patterns of collaboration in each community, we conducted site visits and in-depth interviews with a total of 245 representatives of health care organizations, social service agencies, and local government bodies.

Principal findings

Organizations in higher performing communities regularly worked together to identify challenges faced by older adults in their areas and responded through collective action-in some cases, through relatively unstructured coalitions, and in other cases, through more hierarchical configurations. Further, hospitals in higher performing communities routinely matched patients with needed social services.

Conclusions

The collaborative approaches used by higher performing communities, if spread, may be able to improve outcomes elsewhere.

SUBMITTER: Brewster AL

PROVIDER: S-EPMC6056597 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs.

Brewster Amanda L AL Brault Marie A MA Tan Annabel X AX Curry Leslie A LA Bradley Elizabeth H EH

Health services research 20170919

<h4>Objective</h4>To understand how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older adults.<h4>Study setting</h4>Sixteen Hospital Service Areas (HSAs) in the United States.<h4>Study design</h4>We conducted a qualitative study of HSAs with performance in the top or bottom quartiles nationally across three key outcomes: ambulatory care sensitive hospitalizations, all-cause risk-standard ...[more]

PMID: 28925041

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Project description:BackgroundLyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome - a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States.Objectives1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization.MethodsThis study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure.ResultsLyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, p<.001) and 87% more outpatient visits (95% CI: 86%-89%, p<.001) over a 12-month period, and is associated with 4.77 times greater odds of having any PTLDS-related diagnosis, as compared to controls (95% CI: 4.67-4.87, p<.001). Among those with Lyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses.ConclusionsLyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization.

Dataset Information

Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs.

Objective

Study setting

Study design

Data collection

Principal findings

Conclusions

Publications

Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs.

Similar Datasets

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