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Updated: Jun 25, 2026

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
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Published on: December 9, 2015

The relationship between chronic and non-chronic trends.

Kejian Niu1, Liming Chen, Ying Liu

  • 1Health Management Corporation, Richmond, Virginia 23227, USA. kniu@choosehmc.com

Population Health Management
|February 17, 2009
PubMed
Summary

Evaluating disease management (DM) program costs requires accurate trend adjustments. This study found that using the Annual Qualification method for identifying chronic populations and applying risk adjustment stabilizes the relationship between chronic and non-chronic cost trends.

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Last Updated: Jun 25, 2026

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10:46

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Published on: December 9, 2015

Area of Science:

  • Health economics
  • Healthcare management
  • Biostatistics

Background:

  • Disease management (DM) program outcomes are evaluated using cost trends, often employing the pre-post method.
  • Accurate trend adjustment is critical for the pre-post method, as cost savings estimates are sensitive to trend variations.
  • The Care Continuum Alliance recommends using the non-chronic population's trend to estimate the chronic population's trend.

Purpose of the Study:

  • To analyze the relationship between chronic and non-chronic cost trends in the absence of a DM program.
  • To identify factors influencing the stability of the relationship between chronic and non-chronic trends.
  • To assess the validity of using non-chronic trends for estimating chronic trends in DM outcome evaluations.

Main Methods:

  • Analysis of medical and pharmacy claims data from a large commercial client over a 4-year period.
  • Comparison of the chronic and non-chronic cost trends using different chronic population identification methods (Annual Qualification vs. Prospective).
  • Evaluation of the impact of risk adjustment on the relationship between chronic and non-chronic trends.

Main Results:

  • The method for identifying the chronic population significantly impacts the chronic-non-chronic trend relationship.
  • The Annual Qualification method demonstrated a stable relationship between chronic and non-chronic trends over time.
  • Risk adjustment further stabilized the relationship, causing chronic and non-chronic trends to converge.

Conclusions:

  • The concurrent non-chronic trend can estimate the chronic trend if the Annual Qualification method and risk adjustment are properly applied.
  • This study highlights the importance of validating trend relationships within specific populations before assuming stability.
  • Further research is needed to universally validate the stable relationship between chronic and non-chronic trends.