Abstract
BackgroundThe objective of this paper is to utilise a clinical costing system to investigate differences in the patient journey, defined as the sequence and timing of contacts with the Gold Coast Hospital and Health Services (GCHHS), for four dialysis patient groups defined based on age and gender. It is hypothesised that frequency of contact and form of contact will differ based on both gender and age.MethodsData were provided for 393 patients discharged from the GCHHS facility with dialysis treatment between the 1st of January 2015 and the 31st of December 2016. Features extracted from the data included the number and type of contacts (inpatient admissions, outpatient appointments, and emergency department presentations), the likelihood of subsequent contact types, and time spent in and between contact types. Likelihoods of subsequent contact types were estimated by treating the sequence of contacts observed for each patient as a Markov chain and estimating transition probabilities.ResultsDifferences in patient journey were most prominent when considering age differences, with older patients being characterised by a greater volume of average contacts over the two-year period. The larger volume of average contacts was attributable to shorter times between all types of contacts with the GCHHS as well as an increased volume of inpatient admissions for older patients. Patient journeys did not consistently differ by gender, though some isolated differences were noted for older female patients relative to older male patients.ConclusionsDifferent patient groups are characterised by different patient journeys, and better understanding these differences will facilitate improved management of the resources required to service these patients. Clinical costing systems represent a valuable and easily accessible source of data for formulating institution-specific expectations of healthcare utilisation for different groups.
Highlights
The objective of this paper is to utilise a clinical costing system to investigate differences in the patient journey, defined as the sequence and timing of contacts with the Gold Coast Hospital and Health Services (GCHHS), for four dialysis patient groups defined based on age and gender
Though one study identified by the authors does aim to consider differential outcomes and quality of life for dialysis patients according to a wide range of demographic factors [8], it has not yet been published
This paper aims to use clinical costing information for services provided to patients to assess whether differences in engagement with health services can be identified for four major patient groups defined based on age and gender
Summary
The objective of this paper is to utilise a clinical costing system to investigate differences in the patient journey, defined as the sequence and timing of contacts with the Gold Coast Hospital and Health Services (GCHHS), for four dialysis patient groups defined based on age and gender. Though the incidence of dialysis patients has stabilised in recent years, past increases in patients in this area of the health system, coupled with the relatively high cost of dialysis [4], has motivated research into various aspects of patient treatment, management and experience. While differences in patient experience based on demographic factors have been noted in several studies, these differences have rarely been the primary focus. This is despite the increasing emphasis placed on shared decision-making for patients and physicians based on information which is appropriately personalised [7]. This study is explicitly motivated by the need for greater information for all stakeholders but collection of data with longitudinal survey methods does not allow for immediate results
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