Table 3.
Propensity Score–Adjusted Healthcare Utilization Per Patient Per Eligible Montha
| Patients Treated at Non-CCI Practices, 2008–2010 (n = 2577) | Patients Treated at CCI Practices, 2008–2010 (n = 302) | Difference Between Preindex to Postindex Change in CCI Relative to Non-CCI | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Pre–Index Episode | Post Index Episode | Change Pre-Post | Pre–Index Episode | Post Index Episode | Change Pre-Post | Raw DID | Any: OR (95% CI) Counts: % Change in Expected Mean Count (95% CI) | P | ||
| EDb | Any, % | 63.6% | 71.8% | 8.2% | 81.8% | 80.8% | −1.0% | −9.2% | 1.03 (0.85–1.24) | .79 |
| Count, mean (SD) | 0.208 (0.380) | 0.315 (0.513) | 0.107 | 0.435 (0.710) | 0.426 (0.780) | −0.009 | −0.116 | −4.7% (−15.9% to 8.2%) | .47 | |
| Inpatient | ||||||||||
| Psychiatric and mental healthc | Count, mean (SD) | 0.169 (1.204) | 0.144 (1.123) | −0.025 | 0.173 (0.924) | 0.145 (0.901) | −0.028 | −0.003 | −27.1% (−96.4% to 17.8%) | .28 |
| Substance abusec | Count, mean (SD) | 0.001 (0.013) | 0.000 (0.008) | −0.001 | 0.001 (0.007) | 0.001 (0.010) | 0.000 | 0.001 | 42.6% (−82.8% to 984.5%) | .75 |
| Medical servicesb | Any, % | 85.4% | 90.0% | 4.5% | 94.4% | 96.4% | 2.0% | −2.5% | 0.619 (0.446–0.837) | .002 |
| Count, mean (SD) | 0.841 (1.245) | 1.058 (1.630) | 0.216 | 1.347 (1.683) | 1.524 (2.226) | 0.177 | 0.039 | 1.4% (−4.2% to 7.3%) | .64 | |
| All inpatientb | Any, % | 86.2% | 90.3% | 4.0% | 95.0% | 97.0% | 2.0% | −2.0% | 0.404 (0.280–0.575) | .001 |
| Count, mean (SD) | 1.003 (1.716) | 1.197 (1.950) | 0.193 | 1.512 (1.872) | 1.658 (2.374) | 0.145 | −0.038 | −3.9% (−20.9% to 16.9%) | .69 | |
| Outpatient | ||||||||||
| Psychiatric and mental healthb | Any, % | 31.4% | 33.7% | 2.3% | 39.1% | 36.4% | −2.6% | −4.9% | 0.963 (0.810–1.144) | .67 |
| Count, mean (SD) | 0.300 (0.838) | 0.290 (0.762) | −0.010 | 0.290 (1.169) | 0.236 (0.531) | −0.054 | −0.044 | −11.5% (−22.3% to 64.9%) | .52 | |
| Substance abuseb | Count, mean (SD) | 0.593 (2.811) | 1.039 (4.230) | 0.445 | 0.835 (3.782) | 0.832 (3.526) | −0.003 | −0.448 | −11.7% (−39.4% to 28.7%) | .52 |
| Medical servicesb | Any, % | 92.5% | 96.5% | 4.1% | 96.7% | 99.3% | 2.6% | −1.5% | 0.978 (0.867–1.103) | .71 |
| Count, mean (SD) | 1.310 (1.850) | 1.695 (2.096) | 0.385 | 1.959 (2.691) | 2.458 (2.847) | 0.500 | 0.115 | 11.7% (3.9%–20.3%) | .003 | |
| Pharmacyc | Count, mean (SD) | 2.011 (1.730) | 2.016 (1.663) | 0.005 | 2.241 (1.730) | 2.472 (1.670) | 0.231 | 0.226 | 8.0% (3.2%–13.1%) | .0009 |
| Non-HIV pharmacyc | Count, mean (SD) | 1.829 (1.686) | 1.777 (1.521) | −0.052 | 1.999 (1.633) | 2.204 (1.561) | 0.205 | 0.257 | 9.7% (4.6%–15.1%) | .001 |
| HIV pharmacyc | Count, mean (SD) | 0.254 (0.319) | 0.239 (0.283) | −0.015 | 0.243 (0.299) | 0.267 (0.279) | 0.024 | 0.039 | 1.9% (−6.8% to 11.4%) | .69 |
| All outpatientc | Count, mean (SD) | 4.214 (4.311) | 5.040 (5.448) | 0.826 | 5.326 (5.448) | 5.999 (5.223) | 0.674 | −0.152 | −1.8% (−4.7% to 1.3%) | .25 |
| Total claimsc | Count, mean (SD) | 5.425 (4.979) | 6.551 (6.122) | 1.126 | 7.273 (6.430) | 8.083 (6.264) | 0.810 | −0.406 | −2.5% (−8.0% to 2.8%) | .36 |
CCI indicates Chronic Care Initiative; DID, difference-in-differences; ED, emergency department; OR, odds ratio; ZINB, zero-inflated negative binomial model.
a
”Any” is defined as the proportion of patients with at least 1 claim in each category of service. “Count, mean (SD)” is defined as the mean number of claims per patient per eligible month in each category of service. For ZINB analyses, the mean count is only for those patients with at least 1 claim in that category of service. Negative values for differences favored the CCI group over the non-CCI group and vice versa for positive values.
b
Analyzed using ZINB.
c
Analyzed using negative binomial model.