Extreme Consumers of Health Care: Patterns of Care Utilization in Patients with Multiple Chronic Conditions Admitted to a Novel Integrated Clinic

Figures & data

Figure 1 Flow chart of the patients included in the care utilization analysis.

Table 1 Baseline Demographics and Multimorbidity of Study Groups (Intervention Compared to Control)

Characteristics		Control Arm (STAN)	Intervention Arm (HND)
Number of participants		35	42
Gender	Female	11 (31.4%)	7 (16.7%)
	Male	24 (68.6%)	35 (83.3%)
Age years mean (Median)		76.26 (75)	74.2 (75)
Participants based on age subgroups (%)	50–59	0 (0 %)	1 (2.38%)
	60–69	7 (20%)	9 (21.4%)
	70–79	16 (45.7%)	20 (47.6%)
	80–89	12 (34.3%)	12 (29%)
Median diagnoses per patient (Range)		14.0 (5–44)	17.0 (5–38)
CCI Score
	Median	4.0	5.5
	Mean	4.3	5.4

Abbreviation: CCI, Charlson Comorbidity Index.

Table 2 Comparison of Care Utilization Variables for 24 Months Pre- and 6 Months Post Randomization

Variable Name	Pre Intervention All (−24 to 0 Months)					Post Randomization (+1 to +6 Months) Intervention Arm					Post Randomization (+1 to +6 Months) Control Arm						P-value
	Median		Mean	Range	SD	Median	Mean		Range	SD	Median	Mean		Range		SD
Unplanned visits (per patient per month)
Total (ED + Inpatient)	2.0	1.9		0.0–5.6	1.0	1.0	1.1	0.0–4.6		1.1	1.0	1.3	0.0–7.0		1.5		0.36
ED visits	1.2	1.3		0.0–5.3	0.7	1.0	0.8	0.0–4.6		1.0	1.0	0.8	0.0–4.0		0.9		0.32
Inpatient visits	1.0	0.9		0.0–3.0	0.6	0.0	0.4	0.0–1.5		0.5	0.0	0.5	0.0–3.0		0.7		0.23
Inpatient visits (per patient per month)	1.0	1.0		0.0–3.0	0.7	0.0	0.3	0.0–1.5		0.5	0.0	0.3	0.0–2.5		0.5		0.69
LOS per admission per patient	4.0	4.9		0.5–28.0	4.7	3.5	6.0	0.5–34.0		8.6	4.0	4.8	0.0–13.0		3.7		0.34
Planned outpatient visits (per patient per month)
Non-telephone all	2.8	3.4		1.4–9.6	1.9	3.4	4.2	1.3–17.2		2.9	3.2	4.8	1.4–17		3.6		0.51
Telephone	1.0	1.0		0.0–2.1	0.4	1.2	1.3	0.0–2.6		0.6	1.0	0.9	0.0–2.0		0.5		0.00*
Primary care	1.0	1.2		0.0–12.0	2.1	0.0	0.5	0.0–9.3		1.6	0.0	0.5	0.0–8.0		1.5		0.43
Nurse	2.0	2.6		1.0 −7.3	1.6	2.1	2.6	1.2–7.3		1.4	1.7	2.6	1.0–7.3		1.7		0.10
Physician	0.0	0.4		0.0–3.6	0.7	0.0	0.3	0.0–3.6		0.6	0.0	0.4	0.0–1.6		0.6		0.17

Note: *statistically significant.

Abbreviations: ED, Emergency Department; LOS, Length of Stay.

Table 3 Distribution of Median Visits per Patient and Median Number of Diagnoses per Age Group

	Intervention Arm (n = 42)		Control Arm (n = 35)
	Median Overall (Includes All Types) Visits per Patient (Range)	Median No of Diagnoses per Patient (Range)	Median Overall (Includes All Types) Visits per Patient (Range)	Median No of Diagnoses per Patient (Range)
Age Group (years)
50–59	9.0 (NA) (n = 1)	14.0 (NA) (n = 1)	NA (n = 0)	NA (n = 0)
60–69	12.0 (1–257) (n = 9)	8.0 (4–12) (n = 9)	1.50 (13–61) (n = 7)	8.0 (6–10) (n = 7)
70–79	9.0 (1–522) (n = 20)	13.0 (5–21) (n = 20)	6.0 (6–110) (n = 16)	9.0 (3–19) (n = 16)
80–89	4.50 (1–350) (n = 12)	12.0 (6–30) (n = 12)	9.0 (7–62) (n = 12)	14.0 (7–37) (n = 12)