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- W2324366263 abstract "High utilizers of healthcare resources disproportionately account for a substantial proportion of healthcare costs, especially for diseases characterized by multiple symptoms and comorbidities such as fibromyalgia. This retrospective analysis used electronic health records (EHR) to identify fibromyalgia patients with high resource use and costs. Data were from the Humedica EHR and integrated Optum claims databases from January 1, 2013 to December 31, 2014, consisting of de-identified records including demographics, diagnoses, inpatient/outpatient encounters, medications, procedures, and lab results. Records are linked using Optum-generated identifiers, allowing access to medical and pharmacy claims and costs. Patients were ≥18 years; associated with an integrated delivery network; continuously enrolled during 2013-2014; and had a fibromyalgia diagnosis code (ICD-9 729.1) during the study period. Exclusion criteria were cancer, transplantation, or residency in a nursing inpatient facility. QRMIX was used to partition high utilizers for 12-months post-index by classifying patients into three cost clusters adjusted for demographics; low (n=484), moderate (n=1,166), and high costs (n=1,250), with total costs the sum of emergency room, inpatient, office, outpatient, and prescriptions filled. QRMIX, a finite mixture model that allows for heterogeneity of covariate effects across the distribution of outcomes, partitions data into a specified number of clusters through quantile regression (Willke et al. “A Comparison and Integration of Quantile Regression and Finite Mixture Modeling,” presented at Joint Statistical Meeting 2014, Boston, MA). Mean age was similar across clusters (56.9-57.5 years); patients were primarily female (75.8%-77.8%) and Caucasian (88.0%-89.8%). Median (interquartile range) costs per patient per year were: low cluster, $1,095 ($617-$1,712); moderate cluster, $4,674 ($3,167-$6,762); and high cluster, $19,741 ($13,148-$34,578) with maximum costs of $3,887, $15,022 and $561,308, respectively. We also explored how resources and baseline characteristics vary by cluster. Such information may help develop management strategies that could potentially improve outcomes and reduce healthcare costs. Supported by Pfizer." @default.
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- W2324366263 date "2016-04-01" @default.
- W2324366263 modified "2023-09-23" @default.
- W2324366263 title "(226) Identification of high healthcare resource utilizers among patients with fibromyalgia using electronic health records" @default.
- W2324366263 doi "https://doi.org/10.1016/j.jpain.2016.01.130" @default.
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