Health Hot Spots: Mapping Hospital Costs and Social Determinants of Health


Accountable care organizations (ACOs) and hospitals are facing additional requirements and financial rewards for improving population health. Therefore, ACOs and hospitals will need tools to understand the relationship between their patients and social determinants and health. We demonstrate the use of hot spotting for identifying geographical sources of high hospital costs and examining links between social determinants of health and these high-cost areas, known as hot spots. In 2012, using hospital data, we generated maps of inpatient costs from 2011 throughout New Haven and within an example neighborhood, Dixwell. We defined hot spots as addresses where costs were in the top 25%. We also overlaid data on concerns and assets in the community. Finally, we calculated the number of concerns and assets that fall within the 250 and 500 ft radii of the defined hot spots. We found that 34 addresses in Dixwell accounted for 70% of total costs for Dixwell. Hot spotting is a straightforward, approachable, and easily understood method for ACOs and hospitals to begin to address population health.

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Holzer, J. , Canavan, M. , Cherlin, E. and Bradley, E. (2014) Health Hot Spots: Mapping Hospital Costs and Social Determinants of Health. Open Journal of Preventive Medicine, 4, 717-722. doi: 10.4236/ojpm.2014.49081.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Kaiser Family Foundation (2012) Costs. JAMA, 308, 1197-1197.
[2] Kindig, D. and Stoddart, G. (2003) What Is Population Health? American Journal of Public Health, 93, 380-383.
[3] Gawande, A. (2011) The Hot Spotters. The New Yorker, Conde Nast, New York.
[4] Beck, A.F., Simmons, J.M., Huang, B. and Kahn, R.S. (2012) Geomedicine: Area-Based Socioeconomic Measures for Assessing Risk of Hospital Reutilization among Children Admitted for Asthma. American Journal of Public Health, 102, 2308-2314.
[5] Krieger, N., Chen, J.T., Waterman, P.D., et al. (2003) Choosing Area Based Socioeconomic Measures to Monitor Social Inequalities in Low Birth Weight and Childhood Lead Poisoning: The Public Health Disparities Geocoding Project (US). Journal of Epidemiology Community Health, 57, 186-199.
[6] State & County QuickFacts (2010) New Haven, Connecticut. Cited 2013 Sept 3.
[7] (2013) About Yale-New Haven Hospital. Cited 2013 Sept 3.
[8] (2005) DataHaven Neighborhood Profile: Dixwell. Cited 2013 Sept 3.
[9] Stanton, M.W. (2014) The High Concentration of U.S. Health Care Expenditures: Research in Action. Issue 19, June 2006, Agency for Healthcare Research and Quality, Rockville, MD.
[10] Berkowitz, B. and Wadud. E. (2013) Identifying Community Assets and Resources. The Community Tool Box.
[11] Young, G.J., Chou, C.-H., Alexander, J., Lee, S.-Y.D. and Raver, E. (2013) Provision of Community Benefits by Tax-Exempt U.S. Hospitals. New England Journal of Medicine, 368, 1519-1527.

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