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APHA Scientific Session and Event Listing

Carol L. Macnee, PhD¹, Susan McCabe, EdD¹, Sara Campbell², and Marilyn Fiske, MSN². (1) Fay W. Whitney School of Nursing, University of Wyoming, 1000 E. University, Box 3065, Laramie, WY 82071, 307 766-5483, cmacnee@uwyo.edu, (2) Human Capital Management Services, 1800 Carey Avenue, Suite 300, Cheyenne, WY 82001

Public health nurses are accustomed to basing programs and services on epidemiological data that address population rates/risks. However, it is recognized that unique populations such as poor and uninsured often have significantly higher rates/risks of disease than the population as a whole. While much has been written about factors leading to this unique vulnerability, there is a lack of evidence regarding how poor and uninsured use health care services, leading to programs that may be over or under utilized. This paper proposes that one important source of evidence useful to guide public health nurses in planning heath care services for vulnerable populations is typology modeling of service use patterns based on claims data. Typology models can be a useful way to understand the contexts in which poor and underserved utilize available services. This paper presents a typology model of use of health services by patients drawn from analysis of two different claims data sets. One uses data on visit characteristics including 1) type of provider, 2) number of visits; and 3) intervals between visits to a primary care clinic. The second uses data on 1) number of unique providers; 2) number of services; and 3) interruptions in care of Medicaid clients who have been identified as high risk related to polypharmacy. The typology model results identified distinct patterns of service use. The ability to categorize users of services through typology allows identification of sub-populations that the public health nurse can target with appropriate clinical prevention services.

Learning Objectives:

• Describe the usefulness of typologies of use for planning preventive services to vulnerable populations.
• Analyze health services use data to identify typologies of use relevant to providing clinical preventive services.

Keywords: Clinical Prevention Services, Vulnerable Populations

Presenting author's disclosure statement:

Not Answered