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

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

doi:10.2196/12241

Gang Luo, Adam B Wilcox + Show 2 more

Open Access

https://doi.org/10.2196/12241

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Abstract

BackgroundIn 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.ObjectiveOur objective was to find a way to enable these analysis tasks for a health care system with incomplete data on many of its patients.MethodsThis 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.ResultsFor 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.ConclusionsOur 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.

Highlights

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
Incomplete data are problematic in academic health care systems such as the University of Washington Medicine (UWM), where many patients are referred from other health care systems
We considered the following candidate constraints that all include the component of living within r miles of at least one of the 3 UWM hospitals, with r being a parameter whose optimal value was to be determined in the study: 1. Distance only: The patient lives within r miles of at least one of the 3 UWM hospitals

Summary

Introduction

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. Several major data analysis tasks such as predictive modeling using historical data are deemed impractical on incomplete data. 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. 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

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