Metrics

January 2016 to December 2018

Emergency Room Utilization

The rate of Emergency Room Utilization by Whole Person Care clients. For ever 1,000 people, 284.86 utilized the Emergency Room in 2017. In 2016, this rate is 316.92.
Whole Person Care patients visited the emergency room at a rate of 316 visits per 1000 member-months in 2016, 284 visits per 1000 member-months in 2017, and 210 visits per 1000 member-months in 2018. Because we typically have about 2,000 members enrolled each month, that means that on average, we saw about 420 emergency room visits per month in 2018.

Frequent Emergency Room Diagnoses

For Whole Person Care-enrolled beneficiaries, the most common treat-and-release emergency room diagnostic category across all hospitals was alcohol-related disorders, which accounted for 10% of visits.
If alcohol and substance-related disorders are combined, they together represent 12.6% of all visits.
The second most common diagnostic category at 8.2% was symptoms, signs, and ill-defined conditions, suggesting that there was not a clear diagnosis at the time of the visit.
Together, alcohol, substance abuse, and ill-defined symptoms represent approximately 20% of all emergency room visits during enrollment in the Whole Person Care initiative.
Front of San Mateo Medical Center

Inpatient Services Utilization

Whole Person Care patients had inpatient stays at a rate of 30.5 discharges/1000 member-months in 2016, 29.6 discharges/1000 member-months in 2017, and 27.1 discharges/1000 member-months in 2018. Because we typically have about 2,000 members enrolled each month, that means that on average, we saw about 54 inpatient discharges per month in 2018.
Patient and technician at MRI machine

Frequent Inpatient Diagnoses

For Whole Person Care-enrolled beneficiaries, the most common inpatient diagnostic category across all hospitals were
  • 16.4% schizophrenia and other psychotic disorders
  • 7.9% diabetes mellitus with complications
  • 7.9% alcohol-related disorders
  • 5.4% skin and subcutaneous tissue infections
  • 5.4% bacterial infections
These top 5 diagnostic categories represented 43% of inpatient stays

Diabetes Management

Data shows that 56.94% of clients diagnosed with diabetes had HbA1c below 8 in 2016 compared to 54.91% in 2017. We continue to monitor our clients and implement interventions to increase the number of clients with HbA1c control.