Determinants of High Psychiatric Utilization at a Large Urban Safety-Net Hospital.
| Autor: | Hamilton, Jane E., Suchting, Robert, Buck, David S., Chesnokova, Arina, Das, Sophiya, Allen, Melissa, Cho, Raymond Y. |
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| Předmět: |
STATISTICS
PERSONALITY disorders HEALTH services accessibility SCHIZOPHRENIA RETROSPECTIVE studies MACHINE learning HEALTH status indicators URBAN hospitals MEDICAL care use HEALTH literacy SAFETY-net health care providers HEALTH & social status LOGISTIC regression analysis MENTAL health services ALGORITHMS EDUCATIONAL attainment |
| Zdroj: | Journal of Health Care for the Poor & Underserved; Feb2021, Vol. 32 Issue 1, pN.PAG-N.PAG, 1p |
| Abstrakt: | Research indicates that high utilizers of the health care system are more likely to have mental illness, to be from socially disadvantaged groups, and to have limited access to community-based services. In this retrospective study, three definitions of high utilization were examined: (1) across time: non-high utilization versus high-utilization, (2) single year versus multi-year, and (3) year-to-year. Univariate logistic regression models were fit to a set of 20 theory-selected predictors of high utilization. An optimal multiple predictor model was then derived via penalized multiple logistic regression (via elastic net, a machine learning algorithm). Three factors were identified in the optimized model as increasing the likelihood of high utilization: having a diagnosis of schizophrenia, having a co-occurring personality disorder diagnosis, and having less than a high school education. Given the complex needs of psychiatric high utilizers, innovative approaches should be considered to improve patient outcomes and reduce costly psychiatric hospitalizations. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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