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Proposals for enhanced health risk assessment and stratification in an integrated care scenario

BMJ open, 2016 [Peer Reviewed Journal]

info:eu-repo/semantics/openAccess © Ivan Dueñas-Espín et al. This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com [Creative Commons Attribution License or Creative Commons Attribution Non-Commercial License] http://creativecommons.org/licenses/by-nc/4.0/ ;ISSN: 2044-6055 ;EISSN: 2044-6055 ;DOI: 10.1136/bmjopen-2015-010301

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  • Title:
    Proposals for enhanced health risk assessment and stratification in an integrated care scenario
  • Author: Dueñas-Espín, Iván, 1979 ; Vela, Emili ; Pauws, Steffen ; Bescos, Cristina ; Cano, Isaac ; Clèries, Montse ; Contel, Joan Carles ; Manuel Keenoy, Esteban de ; García Aymerich, Judith ; Gomez Cabrero, David ; Kaye, Rachelle ; Lahr, Maarten M. H ; Lluch-Ariet, Magí ; Moharra, Montserrat ; Monterde, David ; Mora, Joana ; Nalin, Marco ; Pavlickova, Andrea ; Piera, Jordi ; Ponce, Sara ; Santaeugenia, Sebastià ; Schonenberg, Helen ; Stork, Stefan ; Tegnér, Jesper ; Velickovski, Filip ; Westerteicher, Christoph ; Roca Torrent, Josep
  • Subjects: Avaluació ; Malalties cròniques ; Riscos per a la salut
  • Is Part Of: BMJ open, 2016
  • Description: OBJECTIVES: Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. SETTINGS: The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). PARTICIPANTS: Responsible teams for regional data management in the five ACT regions. PRIMARY AND SECONDARY OUTCOME MEASURES: We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. RESULTS: There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. CONCLUSIONS: The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require prospective evaluation. Supported by ACT—Advancing Care Coordination and Telehealth Deployment programme (UE Grant number 20121209), PITES (FIS-PI12/01241) and Generalitat de Catalunya (2014SGR661)
  • Publisher: BMJ Publishing Group
  • Language: English
  • Identifier: ISSN: 2044-6055
    EISSN: 2044-6055
    DOI: 10.1136/bmjopen-2015-010301
  • Source: ProQuest One Psychology
    BMJ Open Access Journals
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    Geneva Foundation Free Medical Journals at publisher websites
    AUTh Library subscriptions: ProQuest Central
    PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
    DOAJ Directory of Open Access Journals
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