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Predicting which patients will be users of expensive care

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A Commonwealth Fund report looks at identifying patients who are more likely to be users of expensive care and more likely to develop a new chronic disease. Some of the findings:

  • “At baseline, poorer patient self-management—as identified by lower patient activation scores—was associated with a higher prevalence of chronic conditions, including depression and high blood pressure, as well as more ED visits and hospital admissions related to these chronic conditions.
  • “After controlling for baseline chronic conditions and demographic characteristics, patients at the lowest activation level at baseline were 25 percent more likely to develop a new chronic disease in the next calendar year compared to patients at the highest activation level. The same analysis two years after baseline showed a 31 percent difference between the lowest and highest activation groups. Three years after baseline, the difference was 21 percent.”
  • “Patients with the lowest activation score at baseline had a 62 percent greater likelihood of having an avoidable hospitalization compared to the most activated group one year later (again, after controlling for baseline demographics and chronic conditions). Two years later, the difference between the least and most activated groups was 40 percent, while three years later the difference was still 30 percent.”The researchers conclude:

    “A patient’s activation level, or ability to self-manage health and health care, is linked to risk of developing a chronic disease and using expensive and avoidable health care services in the future. By stratifying populations by activation level, healthcare delivery systems might better identify and support patients with limited self-management skills, helping to improve outcomes and prevent unnecessary costs.”

    To read the report, please hit this link.

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