A methodology for identifying high-need, high-cost patient personas for international comparisons.
Health Serv Res
; 56 Suppl 3: 1302-1316, 2021 12.
Article
de En
| MEDLINE
| ID: mdl-34755334
ABSTRACT
OBJECTIVE:
To establish a methodological approach to compare two high-need, high-cost (HNHC) patient personas internationally. DATA SOURCES Linked individual-level administrative data from the inpatient and outpatient sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States. STUDYDESIGN:
We outline a methodological approach to identify HNHC patient types for international comparisons that reflect complex, priority populations defined by the National Academy of Medicine. We define two patient profiles using accessible patient-level datasets linked across different domains of care-hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, long-term care, home-health care, and outpatient drugs. The personas include a frail older adult with a hip fracture with subsequent hip replacement and an older person with complex multimorbidity, including heart failure and diabetes. We demonstrate their comparability by examining the characteristics and clinical diagnoses captured across countries. DATA COLLECTION/EXTRACTIONMETHODS:
Data collected by ICCONIC partners. PRINCIPALFINDINGS:
Across 11 countries, the identification of HNHC patient personas was feasible to examine variations in healthcare utilization, spending, and patient outcomes. The ability of countries to examine linked, individual-level data varied, with the Netherlands, Canada, and Germany able to comprehensively examine care across all seven domains, whereas other countries such as England, Switzerland, and New Zealand were more limited. All countries were able to identify a hip fracture persona and a heart failure persona. Patient characteristics were reassuringly similar across countries.CONCLUSION:
Although there are cross-country differences in the availability and structure of data sources, countries had the ability to effectively identify comparable HNHC personas for international study. This work serves as the methodological paper for six accompanying papers examining differences in spending, utilization, and outcomes for these personas across countries.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Plan de recherche
/
Acceptation des soins par les patients
/
Coûts et analyse des coûts
/
Prestations des soins de santé
/
Besoins et demandes de services de santé
Type d'étude:
Health_economic_evaluation
/
Prognostic_studies
Aspects:
Determinantes_sociais_saude
Limites:
Aged
/
Humans
Pays/Région comme sujet:
America do norte
/
Europa
/
Oceania
Langue:
En
Journal:
Health Serv Res
Année:
2021
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique