Conceptualizing lifer versus destination patients for optimized care delivery

Area of Science:

• Health Services Research
• Healthcare Management
• Patient Care Coordination

Background:

• Academic medical centers (AMC) provide primary and specialty care, necessitating tailored care coordination strategies.
• Patient care needs vary significantly between primary and specialty care recipients.
• Optimizing resource allocation requires a clear understanding of patient care pathways.

Purpose of the Study:

• To define "Lifer Patients" and "Destination Patients" within an AMC setting.
• To analyze current care utilization patterns for these distinct patient groups.
• To identify opportunities for enhanced care coordination and resource optimization.

Main Methods:

• Utilized 36-month (FY17-19) AMC data, classifying patients by residence zip code.
• Defined "Lifer Patients" as those with at least one primary care visit.
• Defined "Destination Patients" as those without a primary care visit, using Cohen's effect sizes for utilization analysis.

Main Results:

• Identified 35,909 Lifer Patients and 744,037 Destination Patients.
• Lifer Patients (avg. age 72) had 3x more ambulatory visits than Destination Patients (avg. age 38).
• Destination Patients showed higher emergency department (ED) admission rates and greater length of stay (LOS) variance.

Conclusions:

• Significant differences exist in ambulatory, inpatient, and ED utilization between Lifer and Destination Patients.
• Patient categorization facilitates tailored care coordination strategies.
• The Lifer and Destination Patient framework enables more efficient resource allocation within AMCs.