RESIDENT: Reductions in Health Resource Utilization Following Treatment Using a 4-Phase Model Approach
Presenting Author(s): Dr. Jaylynn Arcand
Co-Author(s): Tyler Pirlot, Tiffany Boulton, Zahinoor Ismail, Glen Hazlewood
Date and time: 25 Mar 2023 from 13:40 to 13:55
Location: Hawthorn B
Learning Objectives
- Understand the current impact standard of care management approaches have on healthcare utilization for adolescent patients with SSRD;
- Understand the change in Emergency Department presentations seen with the use of a four-phase model of SSRD care;
- Understand the change in hospital admissions seen with the use of a four-phase model of SSRD care.
Abstract
Introduction
Somatic Symptom and Related Disorders (SSRD) are associated with high healthcare resource utilization (HRU). A recent administrative data analysis on adolescent SSRD in Ontario found no significant change in HRU after diagnosis of SSRD (1), suggesting limited impact of standard approaches to care on HRU. The Alberta Children’s Hospital Somatic Rehabilitation Clinic (SRC) utilizes a specialized four-phase treatment approach for SSRD which differs from standard practices. This study looks to understand whether treatment at the SRC significantly changes the HRU of patients.
Methods
Administrative data was used to count Emergency Department (ED) visits and hospitalizations for each patient, one year before and after treatment at SRC. Separately, the relationship between the number of ED visits and the number of hospitalizations before and after treatment were assessed through descriptive statistics and regression analysis, controlled for age and sex.
Results
55 patients had 259 ED visits before and 100 ED visits after treatment. 58.2% were frequent healthcare utilizers (4+ presentations/year) before treatment and 15% afterward. Following treatment, the expected reduction in ED visits per person was 61.8% (-1.0, p<0.001). There were 39 hospitalizations before and 14 hospitalization after treatment. Following treatment, the reduction in expected hospitalizations was 61.8% (-0.99, p<0.001).
Conclusions
There is a significant reduction in HRU in patients who received four-phase model treatment for SSRD. While the clinic has only treated a small number of patients, these findings suggest that the four-phase model of care for SSRD may provide significant opportunity to reduce HRU in this population.
Literature References
- Saunders NR, Gandhi S, Chen S, Vigod S, Fung K, De Souza C, et al. Health Care Use and Costs of Children, Adolescents, and Young Adults With Somatic Symptom and Related Disorders. JAMA Netw Open. 2020;3(7):e2011295.