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Utilizing National Survey Data to Benchmark Comprehensive Care in a Large Health System
John S Maier1, Derek Baughman2, Chris Schiermeyer2
1From the University of Pittsburgh, Pittsburgh, PA (JSM, CS, KK); Vanderbilt University, Nashville, TN (DB). jsmaier@pitt.edu.
Background:
Comprehensiveness in primary care is defined as the breadth of services provided by a health care clinician team and is an important metric related to patient outcomes and care delivery. We describe a novel measure of comprehensiveness based on ICD-10 codes.
Methods:
We compare the distribution of ICD-10 codes from the care of a large population at a regional academic health system to the distribution of codes from the National Ambulatory Medical Care Survey (NAMCS) using linear regression and the mathematical inner product.
Results:
The linear regression between the pattern of ICD-10 codes for the selected population and the NAMCS has a slope 1.00, 95% CI 0.57:1.43, P = .0002, R2 0.62. When considering specific specialty areas of practice, primary care is distinct from specialty care based on the inner product between the distribution of care for a given specialty independent of whether a regional or national reference population is used.
Conclusion:
The distribution of care based on ICD-10 codes provides a stable and possibly generalizable reference for comprehensive care. The inner product of an ICD-10 care distribution and a reference provides a quantitative estimate of comprehensiveness that distinguishes primary care from specialty care.
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