Characteristics and Service Utilization by Complex Chronic and Advanced Chronic Patients in Catalonia: A Retrospective Seven-Year Cohort-Based Study of an Implemented Chronic Care Program.
Por:
Sebastià Santaeugènia Gonzàlez, Contel JC, Vela E, Cleries M, Amil P, Melendo-Azuela EM, Gil-Sánchez E, Mir V and Amblàs-Novellas J
Publicada:
8 sep 2021
Ahead of Print:
8 sep 2021
Categoría:
Health, toxicology and mutagenesis
Resumen:
The Chronic Care Program introduced in Catalonia in 2011 focuses on improving the identification and management of complex chronic (CCPs) and advanced chronic patients (ACPs) by implementing an individualized care model. Its first stage is their identification based on chronicity, difficult clinical management (i.e., complexity), and, in ACPs, limited life prognosis. Subsequent stages are individual evaluation and implementation of a shared personalized care plan. This retrospective study, including all CCPs and ACPs identified in Catalonia between 2013 and 2019, was aimed at describing the characteristics and healthcare service utilization among these patients. Data were obtained from an administrative database and included sociodemographic, clinical, and service utilization variables and morbidity-associated risk according to the Adjusted Morbidity Groups (GMA) stratification. During the study period, CCPs' and ACPs' prevalence increased and was higher in lower-income populations; most cases were women. CCPs and ACPs had all comorbidities at higher frequencies, higher utilization of healthcare services, and were more frequently at high risk (63% and 71%, respectively) than age-, sex-, and income level-adjusted non-CCP (23%) and non-ACP populations (30%). These results show effective identification of the program's target population and demonstrate that CCPs and ACPs have a higher burden of multimorbidity and healthcare needs.
Filiaciones:
Sebastià Santaeugènia Gonzàlez:
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Contel JC:
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Vela E:
Unitat d'Informació i Coneixement, Servei Català de la Salut, 08006 Barcelona, Spain
Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, 08006 Barcelona, Spain
Cleries M:
Unitat d'Informació i Coneixement, Servei Català de la Salut, 08006 Barcelona, Spain
Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, 08006 Barcelona, Spain
Amil P:
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Melendo-Azuela EM:
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Gil-Sánchez E:
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Mir V:
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Amblàs-Novellas J:
Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
Chair and Department of Palliative Care, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
Open Access
|