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Research Letter
June 2016

The Adequacy of Individual Hospital Data to Identify High Utilizers and Assess Community Health

Author Affiliations
  • 1Chesapeake Regional Information System for Our Patients, Columbia, Maryland
  • 2Maryland’s Health Services Cost Review Commission, Baltimore
  • 3Audacious Inquiry, Baltimore, Maryland
  • 4Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Intern Med. 2016;176(6):856-858. doi:10.1001/jamainternmed.2016.1248

Many hospitals are analyzing data from their own information systems to develop new strategies to improve population health. Such analyses aim to identify high utilizers who may benefit from additional support and to elucidate community patterns of potentially preventable serious illness, but the extent to which individual hospital data are sufficient for these purposes is unclear.

The Chesapeake Regional Health Information System for Our Patients, Maryland’s Health Information Exchange, aggregates data for all 48 of the state’s acute care hospitals. The Health Information Exchange uses a Master Patient Index based on IBM’s Initiate technology to link admission, discharge, and transfer data, clinical records, and billing diagnoses for unique individuals. As part of a quality improvement initiative and ongoing efforts to support community health planning, using a complete set of admission, discharge, and transfer data, we examined the patterns of hospital use of all patients with more than 5 emergency department visits to Maryland hospitals in calendar year 2014. We also evaluated all hospital admissions for calendar year 2014 to Maryland hospitals to determine the percentage of volume received by the most utilized hospital in each zip code. All 434 zip codes statewide whose residents had more than 10 acute care admissions to a single Maryland hospital and who had more than 99 residents in the 2010 census were included.

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