↓ Skip to main content

High-Cost Patients: Hot-Spotters Don’t Explain the Half of It

Overview of attention for article published in Journal of General Internal Medicine, August 2016
Altmetric Badge

About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)
  • Good Attention Score compared to outputs of the same age and source (70th percentile)

Mentioned by

news
1 news outlet
twitter
3 X users

Citations

dimensions_citation
55 Dimensions

Readers on

mendeley
132 Mendeley
Title
High-Cost Patients: Hot-Spotters Don’t Explain the Half of It
Published in
Journal of General Internal Medicine, August 2016
DOI 10.1007/s11606-016-3790-3
Pubmed ID
Authors

Natalie S. Lee, Noah Whitman, Nirav Vakharia, Glen B. Taksler PhD, Michael B. Rothberg

Abstract

Understanding resource utilization patterns among high-cost patients may inform cost reduction strategies. To identify patterns of high-cost healthcare utilization and associated clinical diagnoses and to quantify the significance of hot-spotters among high-cost users. Retrospective analysis of high-cost patients in 2012 using data from electronic medical records, internal cost accounting, and the Centers for Medicare and Medicaid Services. K-medoids cluster analysis was performed on utilization measures of the highest-cost decile of patients. Clusters were compared using clinical diagnoses. We defined "hot-spotters" as those in the highest-cost decile with ≥4 hospitalizations or ED visits during the study period. A total of 14,855 Medicare Fee-for-service beneficiaries identified by the Medicare Quality Resource and Use Report as having received 100 % of inpatient care and ≥90 % of primary care services at Cleveland Clinic Health System (CCHS) in Northeast Ohio. The highest-cost decile was selected from this population. Healthcare utilization and diagnoses. The highest-cost decile of patients (n = 1486) accounted for 60 % of total costs. We identified five patient clusters: "Ambulatory," with 0 admissions; "Surgical," with a median of 2 surgeries; "Critically Ill," with a median of 4 ICU days; "Frequent Care," with a median of 2 admissions, 3 ED visits, and 29 outpatient visits; and "Mixed Utilization," with 1 median admission and 1 ED visit. Cancer diagnoses were prevalent in the Ambulatory group, care complications in the Surgical group, cardiac diseases in the Critically Ill group, and psychiatric disorders in the Frequent Care group. Most hot-spotters (55 %) were in the "frequent care" cluster. Overall, hot-spotters represented 9 % of the high-cost population and accounted for 19 % of their overall costs. High-cost patients are heterogeneous; most are not so-called "hot-spotters" with frequent admissions. Effective interventions to reduce costs will require a more multi-faceted approach to the high-cost population.

X Demographics

X Demographics

The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 132 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 132 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 20 15%
Student > Master 19 14%
Other 13 10%
Student > Bachelor 12 9%
Student > Ph. D. Student 11 8%
Other 24 18%
Unknown 33 25%
Readers by discipline Count As %
Medicine and Dentistry 40 30%
Nursing and Health Professions 21 16%
Social Sciences 6 5%
Psychology 5 4%
Economics, Econometrics and Finance 4 3%
Other 19 14%
Unknown 37 28%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 April 2022.
All research outputs
#2,971,649
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#2,181
of 7,806 outputs
Outputs of similar age
#54,467
of 372,211 outputs
Outputs of similar age from Journal of General Internal Medicine
#26
of 89 outputs
Altmetric has tracked 23,911,072 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,806 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.8. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 372,211 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 89 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.