Atul Gawande’s refers to them in his New Yorker piece as The Hot Spotters. Just as law enforcement in community policing identifies crime. Can we lower medical costs by giving the neediest patients better care? If Camden, New Jersey, becomes the first American community to. New Yorker. Jan The hot spotters: can we lower medical costs by giving the neediest patients better care? Gawande A. PMID: ; [Indexed .

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Leave a Reply Cancel reply Your email address will not be published. For example, slotters program could be piloted in one clinic and compared with a nearby similar control clinic.

Click here to read the rest of the New Yorker article. The patients were also markedly healthier. Fri, Jun 21st, Nobel peace prize winner Muhammad Yunus is no To their credit, the Camden Coalition has acknowledged that the dramatic data initially reported about their program may be overblown. And he does it so well…. Very few of these programs have reached the level [of success] I would consider convincing,” he said.

You may use these HTML tags and attributes: Cancer Patients and Social Media. While emergency room visits, hospitalizations, and overall costs among enrolled patients may have dropped substantially, there is no telling dpotters patients would have experienced these same improvements even without the program. With this in mind, the dramatic hpt reported about programs like the Camden Coalition seem much less impressive.

By providing follow-up consultation and care to such patients before they might otherwise seek further in-hospital care, “hot-spotting” aims not only to cut healthcare costs associated with repeated hospitalizations, but ultimately to improve the health of those most in need. Gawande also describes a visit he made to the Special Care Center, a clinic in Atlantic City, an experimental approach to primary care. Recent efforts by the Camden Coalition and other similar-minded innovators have inspired atlu much-needed renewed focus on the most complex patients in our healthcare system.

Link to full text in the New Yorkert: But when independent researchers conducted a pre-planned evaluation of the program in which they compared enrolled patients with similar controls, the data gawandf a different story. Nearly everyone involved anticipated success, and indeed enrolled patients experienced substantial improvements in health and reductions in hospitalization rates.

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Most programs in the demonstration focused on patients with chronic conditions who had been hospitalized within the previous year and assigned them to a care coordinator typically a registered nurse who assessed them and developed a plan of care.

This second article in the series explains why targeted programs for high needs, high cost patient populations may not be achieving their intended goals. As a result, many “super-users” of hospital facilities today are likely to stop being high-volume users in the future, regardless of whether they receive intensive targeted services — often referred to as “complex care management” — or not.

This entry was posted in News. Keep Me Updated Signup to recieve latest updates and announcements. According to a report published in the Journal of the American Medical Associationpatients assigned to the control group improved just about as much as those receiving the intensive services. These people averaged gawanxe hospital and E. Yet it is clear these efforts are fhe short of expectations, and much more work — and rigorous evaluation — will be needed to deliver on the promise of better, more efficient care for this population.

He created a way to find the people whose use spotterz medical care was highest, and go after them and provide better care. Unlike other less successful programs in that demonstration, the care coordinators had regular in-person interaction with their assigned patients spotters were closely connected with their patients’ primary care providers.

The best I can do for now is summarize the article and encourage you to either purchase the issue or read it online at a later date.

Even when a randomized trial is not feasible, however, the rigor of a complex care management program evaluation can be enhanced by the inclusion of a matched contemporaneous control population. Joel Greenberg has been a science journalist for four decades.

One of the doctors that works for Verisk, Nathan Gunn, who explains the way data mining can be used to identify the most frequent users of health-care facilities and reduce their costs.

Links to all articles in the series are available on the Gehr Center and Updates in Slow Medicine websites. Brenner’s group defines healthcare hot-spotting as “the strategic use of data to reallocate resources to a small subset of high-needs, high-cost patients. Brenner used data mining and statistical analysis to map health-care use and expenses. A neighborhood couple, a physical therapist and a volunteer firefighter, approached to see if they could help, but police waved them back. Your email address will not be published.


When Jeffrey Brenner, MD, took notice more than a decade ago of the spotty care afforded certain high-risk, high-need patients in Camden, N. Because most coordinators had caseloads of well under patients, they were able to contact their assigned patients frequently — often several times a month or more.

Wed, Jul 10th, Having heard Clay Christensen expound on disruptive If Camden, New Jersey, becomes the first American community to lower its medical costs, it will have a murder to thank. These kinds of cost savings are revolutionary.

The hot spotters: can we lower medical costs by giving the neediest patients better care?

But upon closer inspection, careful analysis of the Camden program and others like it raises concerns that these apparent jaw-dropping improvements may be overstated. In the Hot Spotter article Gawande writes about several innovative approaches to reducing health-care costs.

While it is too early to report data or to draw conclusions from that study, these results should provide insights about the program’s true impact. The most recent was about hospice care. A Critical Look at Healthcare Thw Reform” unpacks the data behind healthcare delivery system interventions, highlighting well-intended reforms that have yet to achieve the impact many have assumed.

Chemistry has the periodic table, physics has Newtonian equations, biology has the theory of evolution. The ideal study design for evaluating hot-spotting approaches, says Asch, is a randomized control trial.

Calibrating the ‘Hot-Spotting’ Hype | Medpage Today

At nine-fifty on a February night ina twenty-two-year-old black man was shot while driving his Ford Taurus station wagon through a neighborhood on the edge of the Rutgers University campus.

The study concluded that, relative to controls, “these programs had favorable effects on none of the adherence measures and only a few of many quality of care indicators examined,” and did not favorably impact the costs of care. With our background practicing naturopathy, much of what Gawande describes seems so obvious, kind of preaching to the choir.

The coordinators also focused their efforts on hospital-to-home care transitions and medication management.

By latehis team had provided care for more than three hundred of these most costly people.