Step 4 Impact Assessments
Impactability modelling can be seen as the next step on, after risk stratification.
It further sorts the sub-groups of at risk patients (from the risk stratification stage) based on how amenable they are to different forms of care.
In other words, impactability models aim to work out what impact an intervention could have. They can address multiple health and care outcomes depending on the parameters used
Where risk stratification sorts individuals into different levels (or strata) of risk, impactability further sorts individuals based on how likely they are to respond (be impacted) by different treatment options.
This can help direct resources most effectively, so that treatments that are most likely to work are used.
A predictive impactability model may be defined as one that
predict[s] who will acquire a disease, an adverse event related to a disease, or change from one health (functioning) state to another, where these outcomes are impactable with some specific intervention such as taking or stopping a medication, doing a test, reducing avoidable medical costs, making a behavioural change, or changing the person’s environment. (Duncan 2004, 91)
When considering impactability, you need to define what it is your are impacting. Typical considerations are:
- Total Cost of Care
- Inpatient Utilization
- Emergency Room Utilization
- Readmissions
- Treatment Adherence
- Disease Severity
- Disease Morbidity
- Mortality
- Social Factors themselves (e.g., Homelessness, Hunger, Poverty)
