ArticleThe Permanente journal2014
Improving care for older adults: a model to segment the senior population.
Article in The Permanente journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Population segmentation based on healthcare needs: a systematic review.Systematic reviews · 2019Pooled it
- A systematic review of the clinical application of data-driven population segmentation analysis.BMC medical research methodology · 2018Pooled it
- A modified and weighted Gower distance-based clustering analysis for mixed type data: a simulation and empirical analyses.BMC medical research methodology · 2024Article
- Association Between Patient Portal Activities and End-of-Life Outcomes Among Deceased Patients in the Last 12 Months of Life.Journal of palliative medicine · 2024Article
- A scoping review of the clinical application of machine learning in data-driven population segmentation analysis.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- A systematic review of risk stratification tools internationally used in primary care settings.Health science reports · 2021Review
- Web-Based Patient Segmentation in Finnish Primary Care: Protocol for Clinical Validation of the Navigator Service in Patients With Diabetes.JMIR research protocols · 2020Article
- Tailoring integrated care services for high-risk patients with multiple chronic conditions: a risk stratification approach using cluster analysis.BMC health services research · 2020Article
- Identifying optimal indicators and purposes of population segmentation through engagement of key stakeholders: a qualitative study.Health research policy and systems · 2020Article
- Identifying subgroups of high-need, high-cost, chronically ill patients in primary care: A latent class analysis.PloS one · 2020Article
- TakingAIM: A Precision Health Framework for Promoting Person-Centered Advance Care Planning.Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association · 2019Article
- Impact of Social Needs Navigation on Utilization Among High Utilizers in a Large Integrated Health System: a Quasi-experimental Study.Journal of general internal medicine · 2019Article
- Predictive ability of an expert-defined population segmentation framework for healthcare utilization and mortality - a retrospective cohort study.BMC health services research · 2019Article
- Identifying heterogeneous health profiles of primary care utilizers and their differential healthcare utilization and mortality - a retrospective cohort study.BMC family practice · 2019Article
- Article
- Assessing the validity of a data driven segmentation approach: A 4 year longitudinal study of healthcare utilization and mortality.PloS one · 2018Article
- Evaluation of a practical expert defined approach to patient population segmentation: a case study in Singapore.BMC health services research · 2017Article
- Primary Care Performance Measurement and Reporting at a Regional Level: Could a Matrix Approach Provide Actionable Information for Policy Makers and Clinicians?Healthcare policy = Politiques de sante · 2016Review
- Identifying Patients at Risk of High Healthcare Utilization.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2016Article
- Identifying Future High Cost Individuals within an Intermediate Cost Population.Quality in primary careArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextRisk stratification and tailored interventions are key population-level care management strategies among older adults, whose needs range from screening and prevention to end-of-life care.
objectiveTo validate the Senior Segmentation Algorithm, a tool using administrative and clinical data from the electronic health record to identify each member aged 65 years and older as belonging to 1 of 4 Care Groups with similar needs: those without chronic conditions, with one or more chronic conditions, with advanced illness or end-organ failure, or with extreme frailty or nearing the end of life.
designMultiple validation methods.
main outcome measuresConcordance with physician judgment, stability of segmentation over time, convergence with mortality, hospitalization, and readmission rates, and costs of care.
resultsConcordance of the algorithm with physician-assessed segmentation of 1615 Medicare recipients was 85%. After 1 year, approximately 85% of 86,140 surviving seniors remained in the same care group; 3.9% moved to a lower need group; and 11% moved to a higher need group. Six-month and 12-month mortality rates varied substantially across care groups. The algorithm performed similarly to the likelihood of hospitalization score in predicting hospitalization and readmissions.
conclusionsThe Senior Segmentation Algorithm accurately identifies older adults in care groups with similar needs, trajectories, and utilization patterns. It is being implemented in all Kaiser Permanente Regions, with the goal of determining key elements of care for members in each group. In addition, future efforts will aim to slow progression to higher need care groups and to identify necessary improvements in delivery system design.
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