Identifying individuals with complex and long-term health-care needs using the Johns Hopkins Adjusted Clinical Groups System: A comparison of data from primary and specialist health care

被引:3
|
作者
Hosar, Rannei [1 ,2 ]
Steinsbekk, Aslak [1 ]
机构
[1] Norwegian Univ Sci & Technol NTNU, Dept Publ Hlth & Nursing, Trondheim, Norway
[2] Norwegian Univ Sci & Technol NTNU, Dept Publ Hlth & Nursing, Postboks 8905, N-7491 Trondheim, Norway
关键词
Population health management; risk stratification; adjusted clinical groups; ACG; complex and long-term health-care needs; MULTIMORBIDITY; VALIDATION; MANAGEMENT;
D O I
10.1177/14034948231166974
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Aims: This study aimed to present the Johns Hopkins Adjusted Clinical Groups (ACG) System risk stratification profile of a total adult population of somatic health-care users when using data from either general practitioners (GPs) or hospital services and to compare the number and characteristics of individuals identified as having complex and long-term health-care needs in each data source. Methods: This was a registry-based study that included all adult residents (N=168,285) in four municipalities in Central Norway who received somatic health care during 2013. Risk profiles were generated using the ACG System based on age, sex and diagnoses registered by GPs or the local hospital. ACG output variables on number of chronic conditions, frailty and concurrent resource utilisation were chosen as indicators of complexity. Results: Nearly nine out of 10 (83.9%) of the population had been in contact with a GP, and 35.4% with the hospital. The mean number of diagnoses (3.0) was equal in both sources. A larger proportion of the population had higher risk scores in all variables except frailty when comparing hospital data to GP data. This was also found when comparing individuals identified as having complex and long-term health-care needs. A similar proportion of the population was found to have complex and long-term health-care needs (hospital 6.7%, GP 6.3%), but only one in five (21.5%) were identified in both data sets. Conclusions: As data from GPs and hospitals identified mostly different individuals with complex and long-term health-care needs, combining data sources is likely to be the best option for identifying those most in need of special attention.
引用
收藏
页码:607 / 615
页数:9
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