ArticleHealth services research2021
A methodology for identifying high-need, high-cost patient personas for international comparisons.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
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- Identifying patterns of clinical conditions among high-cost older adult health care users using claims data: a latent class approach.International journal for equity in health · 2022Article
- International comparison of spending and utilization at the end of life for hip fracture patients.Health services research · 2021Article
- How can we make valid and useful comparisons of different health care systems?Health services research · 2021Article
- A methodology for identifying high-need, high-cost patient personas for international comparisons.Health services research · 2021Article
- International comparison of patient care trajectories: Insights from the ICCONIC project.Health services research · 2021Article
- An international comparison of long-term care trajectories and spending following hip fracture.Health services research · 2021Article
- International comparison of health spending and utilization among people with complex multimorbidity.Health services research · 2021Article
- Differences in health outcomes for high-need high-cost patients across high-income countries.Health services research · 2021Article
- Within and across country variations in treatment of patients with heart failure and diabetes.Health services research · 2021Article
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Authors and funding
32 authors at 13 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo 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. STUDY
designWe 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/EXTRACTION
methodsData collected by ICCONIC partners. PRINCIPAL
findingsAcross 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.
conclusionAlthough 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.
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