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Santa Cruz County Project Connect

Santa Cruz County Project Connect. Measuring Cross-System Outcomes for Enrolled Frequent Users - Methods and Findings to Date 9/28/2006. Outcomes Measured. Post-enrollment change in service utilization for the following settings/services: 2 Hospital Emergency Departments

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Santa Cruz County Project Connect

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  1. Santa Cruz CountyProject Connect Measuring Cross-System Outcomes for Enrolled Frequent Users - Methods and Findings to Date9/28/2006

  2. Outcomes Measured • Post-enrollment change in service utilization for the following settings/services: • 2 Hospital Emergency Departments • Change in number of ED visits and related charges • 2 Hospital Inpatient Units • Change in number of admissions, and number of inpatient days and related charges

  3. Outcomes Measured • 1 Hospital Inpatient Behavioral Health Unit • Change in number of inpatient days and related charges • Ambulance Services (County served by one ambulance company) • Change in number of transports • County Detention Services • Change in number of jail bookings and number of days incarcerated

  4. Outcomes Measured • Also measuring: • Changes in housing status: • Counting number of enrolled individuals entering permanent housing • Changes in benefits status: • Counting number of enrolled individuals qualifying for Soc. Sec. Disability benefits with a new link to Medi-Cal

  5. Methodology • Collect data on service utilization for each enrolled client from each setting/service for the 12-month period prior to enrollment • Collect post-enrollment service utilization data from each source at 3-month intervals

  6. Methodology • Compare 12-month pre-enrollment service utilization (averages for cohort) to: • Annualized post-enrollment service utilization for cohort of all enrolled • Post-enrollment 12-month service utilization for 2 smaller cohorts: 1) those who have been enrolled at least 12-months, and 2) those who have been enrolled at least 24-months

  7. Methodology • Data Collection Methods: • Hospitals: We provide medical record numbers for each enrolled client back to hospitals and they provide us an updated data base with post-enrollment visits and admissions • Ambulance: County EMS program supports ambulance service data base that we are able to access directly

  8. Methodology • Jail Data: Health Services Agency is provided access to jail data base for relevant time periods • Annualizing: • Example: • Total potential days pre-enrollment year = 365 • Total post enrollment days for cohort = 455 • 365/455=.80 • Post-enrollment ambulance transports 466 x 365/455= 374 • Compare 836 transports during 12 mo. Pre-enrollment to 374 transports (annualized) post-enrollment = 55% reduction

  9. Methodology • Charges and Cost: • An average charge-to-cost ratio across 2 hospitals was calculated Spring ‘06. Ratio is used to convert charges to estimated cost • An average cost per booking and jail day was provided by the Sheriff • Charges for ambulance services are based on cost and an average pt. Charge is calculated by AMR each month

  10. Findings to Date • Last data analysis completed includes service utilization through June 30, 2006 • N = 86 individuals enrolled

  11. 51% FEWER JAIL BOOKINGS/COST REDUCTION

  12. 37% DECREASE IN JAIL DAYS/HOUSING COSTS

  13. 55% DECREASE IN AMBULANCE RUNS

  14. DECREASES OF 56% AND 37% IN NUMBER OF ED VISITS AT RESPECTIVE HOSPITALS

  15. 51% AND 47% DECREASE IN HOSPITAL INPATIENT DAYS AT RESPECTIVE HOSPITALS

  16. TOTAL ANNUAL REDUCTION IN INPATIENT CHARGESDOMINICAN: $1,310,512 WATSONVILLE: $1,471,05046% AND 52% REDUCTION IN INPATIENT CHARGES AT RESPECTIVE HOSPITALS

  17. Example of Different MethodologyPresenting ED Visit Data Clients enrolled at least 24 months Compare 1 year pre to 2nd year post Clients enrolled at least 12 months Compare 1 year pre to 1st year post

  18. Project ConnectEstimating Costs from Charges at 2 HospitalsTotal Cost Reduction as of March 2006

  19. Intensive Service Model for Frequent Users Requires a Bigger Investment, but Produces Significant Annual Savings

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