Characteristics of adult primary care patients as predictors of future health services charges.

Published

Journal Article

BACKGROUND: Utilization risk assessment is potentially useful for allocation of health care resources, but precise measurement is difficult. OBJECTIVE: Test the hypotheses that health-related quality of life (HRQOL), severity of illness, and diagnoses at a single primary care visit are comparable case-mix predictors of future 1-year charges in all clinical settings within a large health system, and that these predictors are more accurate in combination than alone. RESEARCH DESIGN: Longitudinal observational study in which subjects' characteristics were measured at baseline, and their outpatient clinic visits and charges and their inpatient hospital days and charges were tracked for 1 year. SUBJECTS: Adult primary care patients. MEASURES: Duke Health Profile for HRQOL, Duke Severity of Illness Checklist for severity of illness, and Johns Hopkins Ambulatory Care Groups for diagnostic groups classification. RESULTS: Of 1,202 patients, 84.4% had follow up in the primary care clinic, 63.2% in subspecialty clinics, 14.8% in the emergency room, and 9.6% in the hospital. Of $6,290,775 total charges, $779,037 (12.2%) was for follow-up primary care. The highest accuracy was found for predicting primary care charges, where R2 for predictors ranged from 0.083 for medical record auditor-reported severity of illness to 0.107 for HRQOL. When predictors were combined, the highest R2 of 0.125 was found for the combination of HRQOL and diagnostic groups. CONCLUSIONS: Baseline HRQOL, severity of illness, and diagnoses were comparable predictors of 1-year health services charges in all clinical sites but most predictive for primary care charges, and were more accurate in combination than alone.

Full Text

Duke Authors

Cited Authors

  • Parkerson, GR; Harrell, FE; Hammond, WE; Wang, XQ

Published Date

  • November 2001

Published In

Volume / Issue

  • 39 / 11

Start / End Page

  • 1170 - 1181

PubMed ID

  • 11606871

Pubmed Central ID

  • 11606871

International Standard Serial Number (ISSN)

  • 0025-7079

Digital Object Identifier (DOI)

  • 10.1097/00005650-200111000-00004

Language

  • eng

Conference Location

  • United States