Introduction
“Super-utilizers”, patients with five or more hospital admissions in the past year, account for half of all healthcare expenditures and present a significant financial burden to our healthcare system. In Pennsylvania “super-utilizers” result in $1.25 billion of healthcare spending and Philadelphia has the highest number of “super-utilizers” in the state. To address this crisis, Jefferson University serves as one of four new national hubs for student hotspotting. Teams of interprofessional health professions students along with faculty and staff advisors enroll “super-utilizers” and provide targeted interventions to address social determinants of health, reduce hospitalizations and improve patient outcomes.
Methods
To examine the impact of this program on patients, objective healthcare outcomes were obtained from EPIC. Costs were obtained from the hospital Care Coordination team and national average figures to examine the impact on the Jefferson health system. Data were collected from six months pre-, during, and post-intervention for the hotspotting intervention group and for a matched control group of non-program participants. Pre- and post-intervention analysis was performed using random effects Poisson regression.
Results
Pre- and post-intervention analysis found a 6% reduction in ED visits, 48% reduction in the number of outpatient visits, 18% reduction in total days in hospital, and 14% reduction in 30 day readmissions for the intervention vs. the control group. Average total costs of care decreased for both the experimental and control group with a 36% cost reduction per patient in the intervention group.
Conclusion
Participation in student hotspotting is a promising way to help address the needs of “super-utilizes”. Student hotspotting appears to have a positive impact on reducing the costs of care and improving health outcomes for high utilizer patients
