Characteristics of Hospital and Emergency Care Super-Utilizers with Multiple Chronic Conditions

L. Jeff Harris
Ilana Graetz
Pradeep S.B. Podila
Jim Wan
Teresa M. Waters
James E. Bailey
Journal Article
April 2016

A retrospective cohort study examined the health care utilization of a group of patients in Memphis, Tennessee who met the enrollment criteria for the SafeMed Program, a care transitions program focused on reducing hospital readmissions and health care costs.

  • The program was open to adult patients with Medicaid and/or Medicare, multiple chronic conditions, and multiple hospitalizations and emergency department (ED) visits within a six-month period.
  • Researchers followed the cohort, tracking hospitalizations and ED visits in the 12 months following the six months of high health care use.
  • In the 12-month period, the cohort of patients had a mean of 3.2 hospitalizations and 2.8 ED visits without hospitalization. Although these patients had at least two chronic conditions, 46 percent said they did not have a primary care provider.
  • The study authors concluded that patients with a history of high health care utilization may continue to use expensive health care services, and may be a good target for intervention.
Posted to The Playbook on
Population Addressed
People with Multiple Chronic Conditions
Key Questions Answered
  • What were the health care utilization patterns of a group of patients identified for inclusion in a care transitions program?
  • Are patients with multiple chronic conditions and a history of hospitalizations likely to continue high utilization?
Level of Evidence
What does this mean?