Description of Instrument
The Phenotype and Outcomes Work Group identified the domains to be included in the definition of Healthcare Utilization:
- Primary Care Outpatient
- Urgent/Emergent Care
- Telemedicine
- Specialty Care
- Procedures/Imaging
- Inpatient Care
Summary of Healthcare Utilization Recommendation
Healthcare Utilization recommendations provide for calculating summary counts of both inpatient and outpatient healthcare utilization. VA clinics that provide outpatients services (Primary Care, Emergency Medicine, Telehealth, etc.) are identified using list of identification are identified in the EHR unique codes (Stop Codes).
The PMC Phenotypes and Outcomes Work Group reviewed several sources that have definitions of VA Stop Codes for Healthcare Utilization including the (1.) the MCA Outpatient Cube definitions, (2.) an HSR ListServ conversation in November of 2020 and (3.) the VSSC Patient Aligned Care Teams Compass Data Definitions (Last Update: 5/22/2020) to ensure a comprehensive list was available for consideration. The Phenotype and Outcomes Work Group reviewed the selected reference lists and made recommendations on how type of outpatient services might be combined to support meaningful analyses. Discussion/decision points included: the groups clinical services (domains) to include and how to define each domain, to exclude pharmacologic and non-pharmacologic pain treatments, to include observation stays in Urgent/Emergent Care, to sub-categorize specialty care to allow granularity, and to have telemedicine as a stand-alone category. In addition, the Work Group recommended employing DRG/MDC definitions developed by Centers for Medicare & Medicaid Services (CMS) to classify utilization of inpatient services. An excel worksheet with the operation definitions recommended was developed and is available to PMC researchers.
