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Related Experiment Video

Updated: May 13, 2025

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Creating an Inclusive Definition for High Users of Inpatient Hospital Systems That Considers Different Levels of

Tomoko McGaughey1, George Kephart2, Utkarsh J Dang1

  • 1Department of Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada.

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|April 16, 2025
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Summary
This summary is machine-generated.

Researchers identified a new definition for high system users (HSUs) in rural Canada. The best definition for rural HSUs involves the top 10% of unplanned hospitalizations for two out of three years.

Keywords:
health policyhigh resource usershigh system usersinpatient hospital carerural healthsurvival analysis

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Area of Science:

  • Health Services Research
  • Rural Health
  • Health Informatics

Background:

  • Existing definitions of high system users (HSUs) do not adequately represent rural populations due to unique accessibility challenges.
  • A validated definition is needed to identify HSUs in rural Canadian communities.

Purpose of the Study:

  • To identify and validate a definition for HSUs specific to rural Canada.
  • To develop a definition that accounts for varying rurality, longitudinal patient data, and diverse hospitalization types.

Main Methods:

  • Utilized the 2011 Canadian Census Health and Environment Cohort (CanCHEC) linkage profile.
  • Analyzed hospitalization experiences from January 1, 2009, to December 31, 2013.
  • Compared common HSU indicators using Cox proportional hazards modeling, considering rurality contextually.

Main Results:

  • The preferred definition for rural HSUs is individuals in the 90th percentile of unplanned hospitalization episodes for two of three consecutive years.
  • This definition incorporates longitudinal patient experiences and multiple hospitalization types.
  • Rurality was assessed as a contextual factor rather than a defining characteristic.

Conclusions:

  • The proposed HSU definition is inclusive and representative of rural Canadian populations.
  • This definition enables better community needs assessment for policy development and resource allocation in rural areas.
  • Tailoring resource allocation to specific rural community needs can improve healthcare access and outcomes.