Scientific Poster Session II - Original Research

Original Research
  Sunday, November 12, 2023
  12:45 PM–02:15 PM

Abstract

Introduction: Multiple chronic conditions can complicate drug therapy, especially among older adults. Pharmacist interventions to optimize medication use can help to better manage chronic conditions. Understanding how chronic condition load (i.e., number of chronic conditions) can impact healthcare utilization is important in developing team-based interventions to address complications.

Research Question or Hypothesis: We hypothesize that a higher chronic condition load is associated with an increased risk of healthcare super-utilization.

Study Design: Retrospective cohort study between Jan. 2019 to Dec. 2021 utilizing data from the Western New York health information exchange.

Methods: Study eligibility included patients =65 years who experienced an unplanned hospital admission during the study period. Chronic conditions were defined based on the CMS Chronic Condition Warehouse. Primary outcome was healthcare super-utilization defined as =3 hospitalizations or =2 hospitalizations and =2 ED visits within 90 days of the post-index hospitalization. Secondary outcome was multiple transition of care (MTOC) defined as =2 healthcare events, including ED visit and hospital readmissions within 30 days of discharge. Logistic regression models were used to examine the relationship between chronic condition load and utilization outcomes (IBM SPSS, Version 28).

Results: There were 85,473 patients included in the study. The average number of chronic conditions was 4.1±3.3 and the most common were hypertension (68%) and cardiovascular disease (72%). Adjusted models showed that each additional chronic condition was associated with a 4% increased risk for super-utilization at 90 days post-discharge (aOR, 1.04; 95% CI 1.02, 1.07; p=0.001). There was no significant relationship between the number of chronic conditions and MTOC at 30 days post-discharge (aOR, 1.01; 95% CI 0.99, 1.02, p=0.52).

Conclusion: These results suggest that each additional chronic condition is associated with an increased risk for healthcare super-utilization at 90 days following hospitalization. Efforts to develop interventions in collaboration with pharmacy are needed to manage patients with multiple chronic conditions and reduce healthcare super-utilization.

Presenting Author

Rongzhen Lu PharmD Candidate
University at Buffalo

Authors

Durdana Iqbal PharmD
University at Buffalo

David M. Jacobs PharmD, PhD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences

Steven Feuerstein MS
University at Buffalo School of Pharmacy and Pharmaceutical Sciences

Robert G. Wahler Jr. PharmD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences

Ranjit Singh MB BChir, MBA
University at Buffalo

Jennifer Stoll PhD
University at Buffalo