Personality could be key to identifying--and diverting--hospital super-users

Hospitals could cut back on inappropriate, expensive care with a simple personality test, a new study in The Milbank Quarterly says. 

The researchers collected data from 1,074 senior citizens who participated in a study funded by the Centers for Medicare & Medicaid Services (CMS). Each of the patients filled out a questionnaire that measures neuroticism, conscientiousness, openness to experience, extraversion and agreeableness.

Over the next two years, participants in the study kept daily journals documenting their use of healthcare services. The researchers found that participants with higher scores for neuroticism were more likely to use emergency departments and custodial nursing homes and spent more days in skilled nursing facilities.

In theory, hospitals could use this information to divert patients who match the profile from the emergency room to a more appropriate--and less expensive care setting, such as a ambulatory care clinics. Hospitals could "design interventions ... that are just as effective," Bruce Friedman, Ph.D., an associate professor in the University of Rochester Medical Center Department of Public Health Sciences and the study's lead author said in a university statement.

Participants with higher levels of openness to experience were also more likely to use custodial nursing homes, as were those with higher agreeableness and those with lower conscientiousness. Lower openness was associated with more time in skilled nursing facilities, and both lower openness and lower conscientiousness correlated with more emergency department use.

Another way hospitals can cut costs and improve patient care for so called healthcare "super-users" is to set up care delivery models that target patients who have a history of frequent encounters with healthcare providers, FierceHealthcare recently reported.

And some hospitals have found coordinated care can help keep these super-users out of the emergency room. 

To learn more:
- here's the study abstract
- read the URMC announcement