Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties
Abstract Backgrounds and aims This article develops a Specialty Intensity Score, which uses patient diagnosis codes to estimate the number of specialist physicians a patient will need to access. Conceptually, the score can serve as a proxy for a patient's need for care coordination across docto...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-06-01
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| Series: | Health Science Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/hsr2.303 |
| _version_ | 1819138568951431168 |
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| author | Ashley Hodgson Thomas Bernardin Benjamin Westermeyer Ella Hagopian Tyler Radtke Ahmed Noman |
| author_facet | Ashley Hodgson Thomas Bernardin Benjamin Westermeyer Ella Hagopian Tyler Radtke Ahmed Noman |
| author_sort | Ashley Hodgson |
| collection | DOAJ |
| description | Abstract Backgrounds and aims This article develops a Specialty Intensity Score, which uses patient diagnosis codes to estimate the number of specialist physicians a patient will need to access. Conceptually, the score can serve as a proxy for a patient's need for care coordination across doctors. Such a measure may be valuable to researchers studying care coordination practices for complex patients. In contrast with previous comorbidity scores, which focus primarily on mortality and utilization, this comorbidity score approximates the complexity of a patient's the interaction with the health care system. Methods We use 2015 inpatient claims data from the Centers for Medicare and Medicaid Services to model the relationship between a patient's diagnoses and physician specialty usage. We estimate usage of specialist doctors by using a least absolute shrinkage and selection operator Poisson model. The Specialty Intensity Score is then constructed using this predicted specialty usage. To validate our score, we test its power to predict the occurrence of patient safety incidents and compare that with the predictive power of the Charlson comorbidity index. Results Our model uses 127 of the 279 International Classification of Disease, 10th Revision, Clinical Modification (ICD‐10‐CM) diagnosis subchapters to predict specialty usage, thus creating the Specialty Intensity Score. This score has significantly greater power in predicting patient safety complications than the widely used Charlson comorbidity index. Conclusion The Specialty Intensity Score developed in this article can be used by health services researchers and administrators to approximate a patient's need for care coordination across multiple specialist doctors. It, therefore, can help with evaluation of care coordination practices by allowing researchers to restrict their analysis of outcomes to the patients most impacted by those practices. |
| first_indexed | 2024-12-22T11:08:51Z |
| format | Article |
| id | doaj.art-79e6789123254867b1dd397bfe29f41a |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-12-22T11:08:51Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-79e6789123254867b1dd397bfe29f41a2022-12-21T18:28:13ZengWileyHealth Science Reports2398-88352021-06-0142n/an/a10.1002/hsr2.303Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialtiesAshley Hodgson0Thomas Bernardin1Benjamin Westermeyer2Ella Hagopian3Tyler Radtke4Ahmed Noman5St. Olaf College Northfield MinnesotaSt. Olaf College Northfield MinnesotaSt. Olaf College Northfield MinnesotaSt. Olaf College Northfield MinnesotaSt. Olaf College Northfield MinnesotaSt. Olaf College Northfield MinnesotaAbstract Backgrounds and aims This article develops a Specialty Intensity Score, which uses patient diagnosis codes to estimate the number of specialist physicians a patient will need to access. Conceptually, the score can serve as a proxy for a patient's need for care coordination across doctors. Such a measure may be valuable to researchers studying care coordination practices for complex patients. In contrast with previous comorbidity scores, which focus primarily on mortality and utilization, this comorbidity score approximates the complexity of a patient's the interaction with the health care system. Methods We use 2015 inpatient claims data from the Centers for Medicare and Medicaid Services to model the relationship between a patient's diagnoses and physician specialty usage. We estimate usage of specialist doctors by using a least absolute shrinkage and selection operator Poisson model. The Specialty Intensity Score is then constructed using this predicted specialty usage. To validate our score, we test its power to predict the occurrence of patient safety incidents and compare that with the predictive power of the Charlson comorbidity index. Results Our model uses 127 of the 279 International Classification of Disease, 10th Revision, Clinical Modification (ICD‐10‐CM) diagnosis subchapters to predict specialty usage, thus creating the Specialty Intensity Score. This score has significantly greater power in predicting patient safety complications than the widely used Charlson comorbidity index. Conclusion The Specialty Intensity Score developed in this article can be used by health services researchers and administrators to approximate a patient's need for care coordination across multiple specialist doctors. It, therefore, can help with evaluation of care coordination practices by allowing researchers to restrict their analysis of outcomes to the patients most impacted by those practices.https://doi.org/10.1002/hsr2.303care coordinationcomorbidity scoreinpatientsmedical specializationpatient safety incidents |
| spellingShingle | Ashley Hodgson Thomas Bernardin Benjamin Westermeyer Ella Hagopian Tyler Radtke Ahmed Noman Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties Health Science Reports care coordination comorbidity score inpatients medical specialization patient safety incidents |
| title | Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties |
| title_full | Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties |
| title_fullStr | Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties |
| title_full_unstemmed | Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties |
| title_short | Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties |
| title_sort | development of a specialty intensity score to estimate a patient s need for care coordination across physician specialties |
| topic | care coordination comorbidity score inpatients medical specialization patient safety incidents |
| url | https://doi.org/10.1002/hsr2.303 |
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