In previous blog posts we have discussed the analytics needs for population health management. One significant population that has been historically underserved by analytics is the pediatrics population. Recently, there has been renewed interest in managing the care and cost of this population. Some of the interest has been generated by CMMI grants in managing pediatric care and the rapid expansion of children in the Children Health Insurance program (CHIP) and Medicaid expansion.
Defining the Pediatric Population
This is a relatively simple population to define, typically using birth date to define the population. Many define the population from birth to 18 years of age. Often the population is further sub-divided into infants (0 – 1 ages), children (2-12 years old) and adolescents (13-18 years old). Another typical method of sub-dividing the population is by payer and program, with Medicaid programs such as CHIP and TANF/AFDC and commercial payers. Other important ways of segmenting this population are by socio-economic status, geography and by disease state. Milliman has developed a tool that hierarchically assigns patients to a single pre-dominant disease (chronic condition hierarchical groups) and is currently developing a pediatric version of this analytic.
Pediatric Specific Analytics
Effective population health management requires a balanced set of metrics to profile and target improvements for the population. It requires healthcare quality, care delivery efficiency, patient safety, cost, and utilization metrics. The ability to benchmark the specific pediatrics population is also critical to be able to target, plan and measure the impact of interventions. Below is a sample of the metrics that should be available to manage pediatrics populations.
These metrics are examples of the tools that need to be available within analytic systems to be able to effectively manage pediatrics populations. It will become increasingly important to have specific measures that are relevant to the unique characteristics of populations that are being managed.