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Publication Date

7-18-2014

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Advisor: R Brawer, Jefferson Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA

Abstract

The purpose of this mixed-methods study was to explore super utilizers’ perceptions of the influence of Adverse Childhood Experiences (ACEs) on their health and lives. This study additionally compared the super utilizers’ ACE scores to normative ACE data described in the literature. Eligible participants were medically and psychosocially complex patients who had completed the Camden Coalition’s Care Management intervention. 22 participants were enrolled in the study and interviewed in their homes in Camden, NJ. The survey included 9 ACE questions with follow up qualitative interview questions designed to elicit information about the impact of ACES on their lives. Participants’ ACE scores were compared to the general population’s ACE data. Interview transcripts were transcribed and content analysis conducted. The general population has an average ACE score of 1.4 while this super utilizer population had an average ACE score of 2.9. 9 out of 22 (41%) of super utilizers experienced at least 4 ACEs while only 12.5% of the general population has experienced 4 or more ACEs. In the 13 qualitative interviews, super utilizers who had an ACE score of 3 or higher all reported suffering from mental illness. Super utilizers appear to suffer from more ACEs on average than the general population. ACEs may predict high utilization of hospital services. Future mixed methods studies with super utilizers should be conducted with larger sample sizes to further investigate these findings.

Presentation: 23 minutes

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