Identifying Patients Who Are Likely to Receive Most of Their Care From a Specific Health Care System: Demonstration via Secondary Analysis

Gang Luo; Peter Tarczy-Hornoch; Adam B Wilcox; E Sally Lee

doi:10.2196/12241

Identifying Patients Who Are Likely to Receive Most of Their Care From a Specific Health Care System: Demonstration via Secondary Analysis

JMIR Med Inform. 2018 Nov 5;6(4):e12241. doi: 10.2196/12241.

Authors

Gang Luo¹, Peter Tarczy-Hornoch^{1

2

3}, Adam B Wilcox¹, E Sally Lee⁴

Affiliations

¹ Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States.
² Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, United States.
³ Department of Computer Science and Engineering, University of Washington, Seattle, WA, United States.
⁴ Population Health Analytics, University of Washington Medicine Finance, University of Washington, Seattle, WA, United States.

PMID: 30401670
PMCID: PMC6246965
DOI: 10.2196/12241

Abstract

Background: In the United States, health care is fragmented in numerous distinct health care systems including private, public, and federal organizations like private physician groups and academic medical centers. Many patients have their complete medical data scattered across these several health care systems, with no particular system having complete data on any of them. Several major data analysis tasks such as predictive modeling using historical data are considered impractical on incomplete data.

Objective: Our objective was to find a way to enable these analysis tasks for a health care system with incomplete data on many of its patients.

Methods: This study presents, to the best of our knowledge, the first method to use a geographic constraint to identify a reasonably large subset of patients who tend to receive most of their care from a given health care system. A data analysis task needing relatively complete data can be conducted on this subset of patients. We demonstrated our method using data from the University of Washington Medicine (UWM) and PreManage data covering the use of all hospitals in Washington State. We compared 10 candidate constraints to optimize the solution.

Results: For UWM, the best constraint is that the patient has a UWM primary care physician and lives within 5 miles of at least one UWM hospital. About 16.01% (55,707/348,054) of UWM patients satisfied this constraint. Around 69.38% (10,501/15,135) of their inpatient stays and emergency department visits occurred within UWM in the following 6 months, more than double the corresponding percentage for all UWM patients.

Conclusions: Our method can identify a reasonably large subset of patients who tend to receive most of their care from UWM. This enables several major analysis tasks on incomplete medical data that were previously deemed infeasible.

Keywords: data analysis; emergency departments; health care system; inpatients.

©Gang Luo, Peter Tarczy-Hornoch, Adam B Wilcox, E Sally Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 05.11.2018.

Grants and funding

R01 HL142503/HL/NHLBI NIH HHS/United States