Strategic Use of Population-Based Information (groups of patients with similar chronic health problems) for Improving Health RAND Data: An Example of Population Management Trina Dutta, MPP, MPH
Findings: PBHCI Preliminary Follow-up Evaluation Report
- Percent of clients seeing Primary Care Provider: 75.6% Percent of clients seeing Primary Care Provider: 75.6% This means that for Cohorts I and II, 75.6% of clients This means had that seen for Cohorts a Primary I and II, Care 75.6% Provider of clients at had least seen a once Primary by Care the Provider end at least of once their by first the end year of their enrolled first year in enrolled PBHCI. in PBHCI. Target: 100% Providers Providers Seen Seen from from Enrollment Enrollment to to End of of First Year Target: 100%
Physical Health Service Utilization from Enrollment to End of First First Year - Percent of Clients Using Screening/Assessment Service: 83.7% Percent of Clients Using Screening/Assessment Service: 83.7% This means that for Cohorts I and II, 83.7% of clients had a physical health screening/assessment This means that for Cohorts I and II, 83.7% of clients had a physical health screening/assessment performed at least once by the end of their first year enrolled performed in PBHCI. at least once by the end of their first year enrolled in PBHCI. Target: 100% Target: 100%
Substance Use Service Utilization from Substance Use Service Utilization from Enrollment to End of First Year Enrollment to End of First Year - Percent of of Clients Using Screening/Assessment Service: 57.3% This means that that for Cohorts for Cohorts I and II, 57.3% I and of II, clients 57.3% had a of substance clients use had screening/assessment performed by the end of their first year enrolled in a PBHCI. substance use screening/assessment performed by the end of their first year enrolled in PBHCI. Target: 100% Target: 100% Percent of Clients Using Referral Service: 6.9% Percent This of means Clients that Using for Cohorts Referral I and Service: II, 6.9% of clients This were means given a that referral for Cohorts to a substance I and II, use 6.9% provider of clients by the were given end of a their referral first to year a substance enrolled in use PBHCI. provider by the end of their FYI: first 22.0, year 27.2% enrolled of clients in PBHCI. are using illegal substances or FYI: binge 22.0, drinking, 27.2% respectively of clients are using illegal substances or binge drinking, respectively
Wellness Service Utilization from Wellness Service Utilization from Enrollment to End of First Year Enrollment to End of First Year Percent of Clients Using Any Wellness Service: 70.3% - Percent of Clients Using Any Wellness Service: 70.3% This means that for Cohorts I and II, 70.3% of clients used any This means that for Cohorts I and II, 70.3% of clients used any wellness service at all by the end of their first year enrolled in wellness service at all by the end of their first year enrolled in PBHCI. PBHCI. Percent of Clients Using Smoking Cessation: 23.7% - Percent of Clients Using Smoking Cessation: 23.7% FYI: 61.3% percent of clients are smokers FYI: 61.3% percent of clients are smokers Percent of Clients Using Wellness Education: 46.3% - Percent of Clients Using Wellness Education: 46.3% Percent of Clients Using Exercise: 23.4% - Percent of Clients Using Exercise: 23.4%
Quality of Care for Physical Health Quality of Care for Physical Health Conditions Conditions - Patients with diabetes that received education services related to diabetes, nutrition, cooking, physical activity, or exercise within 1 year of enrolling in PBHCI: 66.5% Target: 100% - Patients with hypertension that received education services related to hypertension, nutrition, cooking, physical activity, or exercise within 1 year of enrolling in PBHCI: 55.2% Target: 100% - Patients identified as tobacco users who received cessation intervention during the two-year measurement period: 28.6% Target: 100%