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Multimorbidity patterns in high-need, high-cost elderly patients
Alessandra Buja1, Mirko Claus1, Lucia Perin2
1Department of Cardiologic, Vascular, and Thoracic Sciences and Public Health, University of Padova, Padova, Italy.
Plos One
|December 18, 2018
Summary
Identifying common disease combinations in elderly patients with complex health care needs (PCHCN) can improve care delivery. This study found five distinct clusters of chronic conditions, aiding tailored interventions for PCHCN.
Area of Science:
- Gerontology
- Public Health
- Health Services Research
Background:
- Patients with complex health care needs (PCHCN) represent a significant burden on healthcare resources due to extensive and costly care requirements.
- Tailoring care delivery processes and teams to patient subgroups with similar needs is crucial for value-based primary care.
- Understanding the patterns of chronic conditions in PCHCN is essential for optimizing healthcare resource allocation.
Purpose of the Study:
- To describe the most frequent chronic conditions and their combinations within a cohort of elderly PCHCN.
- To identify distinct patterns of multimorbidity in this patient population.
- To provide insights for better organizing interventions for PCHCN.
Main Methods:
- Analysis of a cohort of elderly PCHCN from Azienda ULSS4-Veneto, specifically those in Resource Utilization Bands 4 and 5.
- Extraction and combination of Expanded Diagnosis Clusters with Rx-MGs diagnoses.
- Application of latent class analysis to identify morbidity patterns, focusing on dyads and triads of 15 selected diseases/disorders.
Main Results:
- Five primary disease clusters were identified in the PCHCN cohort.
- These clusters included metabolic-ischemic heart diseases, neurological and mental disorders, cardiac diseases (e.g., congestive heart failure, atrial fibrillation), respiratory conditions, and neoplasms.
- Specific, common associations between chronic diseases were revealed.
Conclusions:
- The study identified distinct patterns of multimorbidity in elderly patients with complex health care needs.
- Understanding these disease associations can inform more effective and targeted interventions.
- This research contributes to better organization and delivery of care for PCHCN.
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