Related Experiment Video
Updated: Dec 10, 2025
14:32
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
24.2K
High-need high-cost patients: A Concept Analysis
1Columbia University School of Nursing, New York, New York, USA.
Nursing Forum
|August 28, 2020
Summary
High-need, high-cost (HNHC) patients, who drive most US healthcare expenses, are challenging to manage due to varied definitions. This study identified three key subgroups and a feedback loop contributing to their complex care needs.
Area of Science:
- Health Services Research
- Healthcare Management
- Public Health
Background:
- High-need, high-cost (HNHC) patients represent a small population segment responsible for a disproportionate share of US healthcare expenditures.
- The lack of a unified definition for HNHC patients hinders the development and effectiveness of interventions targeting disease management and cost reduction.
Purpose of the Study:
- To clarify the defining attributes of high-need, high-cost patients through a comprehensive literature review.
- To identify distinct subgroups within the HNHC patient population.
- To elucidate the core characteristics and contributing factors associated with HNHC patients.
Main Methods:
- A literature review was conducted using the Walker and Avant method of concept analysis.
- Two major databases, PubMed and CINAHL, were systematically searched to identify relevant studies.
- Included studies focused on the definition, characteristics, and management of high-need, high-cost patients.
Main Results:
- Three primary subgroups of HNHC patients were identified: adults with multiple chronic conditions and functional disability, the frail elderly, and individuals under 65 with a disability or behavioral health condition.
- HNHC patients are characterized by a cycle of acute exacerbations on chronic conditions, frequent utilization of preventable health services, and fragmented care delivery.
- Antecedent factors contributing to HNHC status include difficulties accessing timely care, low socioeconomic status, insufficient social support, and social isolation.
Conclusions:
- Establishing clear definitions and identifying subgroups of HNHC patients is crucial for developing targeted and effective healthcare interventions.
- Understanding the feedback loop of chronic conditions, service utilization, and care fragmentation is key to improving outcomes for HNHC populations.
- Addressing socioeconomic and social determinants of health is essential for preventing individuals from becoming high-need, high-cost patients.
More Related Videos
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
766
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
766
01:21Planning Nursing Care I
5.4K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
5.4K
01:18Introduction To Health Care Delivery System
3.6K
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
3.6K
01:13Patient-centered Care
2.7K
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
2.7K
01:29Documentation in Long-Term and Home Healthcare Setting
1.3K
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
1.3K
01:26Methods Of Healthcare Delivery System
3.8K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.8K