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Primary care practices use risk stratification (RS) to manage patient care. Confidence in risk scores is moderate, but higher when human review is included, especially in smaller, independent practices.

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Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Health Informatics

Background:

  • Risk stratification (RS) is crucial for allocating care management (CM) resources effectively in primary care.
  • Understanding primary care practices' perceptions and approaches to RS is essential for optimizing its implementation.
  • Existing research often lacks detailed insights into the practical application and confidence levels associated with RS in diverse practice settings.

Purpose of the Study:

  • To investigate the current approaches and perceptions of risk stratification (RS) within primary care practices.
  • To assess the level of confidence primary care professionals have in their risk assessment tools and subsequent care management workflows.
  • To identify practice characteristics associated with higher confidence and agreement with risk scores.

Main Methods:

  • An online survey was developed, validated, and administered to 148 representatives from 37 primary care practices utilizing RS.
  • The survey collected data on practices' RS approaches, perceptions, confidence levels, and impact on CM activities.
  • Statistical analyses, including chi-square tests, were performed to examine associations between practice characteristics and confidence in RS.

Main Results:

  • The survey achieved a 68% response rate, with 100 usable responses.
  • Participants reported moderate confidence in their risk scores (41-53.8%) and moderate to high confidence in CM workflows (46-68%).
  • Small and independent practices showed higher confidence and agreement with RS (p < 0.01), and confidence was greatest when human review was integrated into RS processes (p < 0.05).

Conclusions:

  • Primary care practices have a moderate level of confidence in their risk stratification tools and associated care management.
  • Incorporating human review into risk stratification processes significantly enhances confidence, regardless of respondent's professional role.
  • Findings suggest that tailoring RS implementation strategies to practice size and ownership, and emphasizing human oversight, can improve effectiveness.