Manager   •   about 4 years ago

Q: Can you speak to the geographic relationships of super-utilizers, are they generally located in the same neighborhoods? Blocks?

A: There is limited research and data relating to the geographic patterns of super-utilizers. In urban areas, it appears that this population is typically concentrated in low-income areas. However, there are vast differences between urban, rural, and suburban regions, so this may not be true elsewhere. There is some solid data from an analysis in Camden, NJ, where a doctor named Jeffrey Brenner of the Camden Coalition of Healthcare Providers used data from the city’s major hospitals and mapped out where most of the super-utilizer patients lived to find what he called “hot spots.” It turned out the two most expensive city blocks were in north Camden, one that had a large nursing home and one that had a low-income housing tower. You can read more about this in an article from the New Yorker that is posted on the Resources tab: http://www.newyorker.com/magazine/2011/01/24/the-hot-spotters.

Another trend to keep in mind is that in urban areas there are typically more choices for where to receive care (e.g., more hospitals, clinics, etc.), and it is not unusual to see these individuals getting medical or behavioral health care from a variety of locations, not just the one that is geographically closest to them. This contributes to the fragmented care that this population experiences, as information is rarely shared across these systems to give providers or case managers a complete picture of the patients' conditions or needs.

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