Differences in health outcomes for high-need high-cost patients across high-income countries.

Papanicolas, I; Riley, K; Abiona, O; Arvin, M; Atsma, F; Bernal-Delgado, E; Bowden, N; Blankart, CR; Deeny, S; Estupiñán-Romero, F; Gauld, R; Haywood, P; Janlov, N; Knight, H; Lorenzoni, L; Marino, A; Or, Z; Penneau, A; Schoenfeld, AJ; Shatrov, K; Stafford, M; van de Galien, O; van Gool, K; Wodchis, W; Jha, AK; Figueroa, JF

Differences in health outcomes for high-need high-cost patients across high-income countries.

Papanicolas, I Riley, K Abiona, O

Arvin, M Atsma, F Bernal-Delgado, E Bowden, N Blankart, CR Deeny, S Estupiñán-Romero, F Gauld, R Haywood, P

Janlov, N Knight, H Lorenzoni, L Marino, A Or, Z Penneau, A Schoenfeld, AJ Shatrov, K Stafford, M van de Galien, O van Gool, K Wodchis, W Jha, AK Figueroa, JF

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Health services research, 2021, 56 Suppl 3, (S3), pp. 1347-1357
Issue Date:: 2021-12

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Field	Value	Language
dc.contributor.author	Papanicolas, I
dc.contributor.author	Riley, K
dc.contributor.author	Abiona, O https://orcid.org/0000-0002-1696-4475
dc.contributor.author	Arvin, M
dc.contributor.author	Atsma, F
dc.contributor.author	Bernal-Delgado, E
dc.contributor.author	Bowden, N
dc.contributor.author	Blankart, CR
dc.contributor.author	Deeny, S
dc.contributor.author	Estupiñán-Romero, F
dc.contributor.author	Gauld, R
dc.contributor.author	Haywood, P https://orcid.org/0000-0001-5031-8648
dc.contributor.author	Janlov, N
dc.contributor.author	Knight, H
dc.contributor.author	Lorenzoni, L
dc.contributor.author	Marino, A
dc.contributor.author	Or, Z
dc.contributor.author	Penneau, A
dc.contributor.author	Schoenfeld, AJ
dc.contributor.author	Shatrov, K
dc.contributor.author	Stafford, M
dc.contributor.author	van de Galien, O
dc.contributor.author	van Gool, K
dc.contributor.author	Wodchis, W
dc.contributor.author	Jha, AK
dc.contributor.author	Figueroa, JF
dc.date.accessioned	2021-12-15T04:43:48Z
dc.date.available	2021-07-12
dc.date.available	2021-12-15T04:43:48Z
dc.date.issued	2021-12
dc.identifier.citation	Health services research, 2021, 56 Suppl 3, (S3), pp. 1347-1357
dc.identifier.issn	0017-9124
dc.identifier.issn	1475-6773
dc.identifier.uri	http://hdl.handle.net/10453/152350
dc.description.abstract	<h4>Objective</h4>This study explores variations in outcomes of care for two types of patient personas-an older frail person recovering from a hip fracture and a multimorbid older patient with congestive heart failure (CHF) and diabetes.<h4>Data sources</h4>We used individual-level patient data from 11 health systems.<h4>Study design</h4>We compared inpatient mortality, mortality, and readmission rates at 30, 90, and 365 days. For the hip fracture persona, we also calculated time to surgery. Outcomes were standardized by age and sex.<h4>Data collection/extraction methods</h4>Data was compiled by the International Collaborative on Costs, Outcomes and Needs in Care across 11 countries for the years 2016-2017 (or nearest): Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.<h4>Principal findings</h4>The hip sample across ranged from 1859 patients in Aragon, Spain, to 42,849 in France. Mean age ranged from 81.2 in Switzerland to 84.7 in Australia, and the majority of hip patients across countries were female. The congestive heart failure (CHF) sample ranged from 742 patients in England to 21,803 in the United States. Mean age ranged from 77.2 in the United States to 80.3 in Sweden, and the majority of CHF patients were males. Average in-hospital mortality across countries was 4.1%. for the hip persona and 6.3% for the CHF persona. At the year mark, the mean mortality across all countries was 25.3% for the hip persona and 32.7% for CHF persona. Across both patient types, England reported the highest mortality at 1 year followed by the United States. Readmission rates for all periods were higher for the CHF persona than the hip persona. At 30 days, the average readmission rate for the hip persona was 13.8% and 27.6% for the CHF persona.<h4>Conclusion</h4>Across 11 countries, there are meaningful differences in health system outcomes for two types of patients.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation	The Health Foundation
dc.relation.ispartof	Health services research
dc.relation.isbasedon	10.1111/1475-6773.13735
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights	This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited
dc.subject	1117 Public Health and Health Services, 1605 Policy and Administration
dc.subject.classification	Health Policy & Services
dc.title	Differences in health outcomes for high-need high-cost patients across high-income countries.
dc.type	Journal Article
utslib.citation.volume	56 Suppl 3
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1605 Policy and Administration
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	recently_added	*
dc.date.updated	2021-12-15T04:43:44Z
pubs.issue	S3
pubs.publication-status	Published
pubs.volume	56 Suppl 3
utslib.citation.issue	S3

Abstract:

Objective

This study explores variations in outcomes of care for two types of patient personas-an older frail person recovering from a hip fracture and a multimorbid older patient with congestive heart failure (CHF) and diabetes.

Data sources

We used individual-level patient data from 11 health systems.

Study design

We compared inpatient mortality, mortality, and readmission rates at 30, 90, and 365 days. For the hip fracture persona, we also calculated time to surgery. Outcomes were standardized by age and sex.

Data collection/extraction methods

Data was compiled by the International Collaborative on Costs, Outcomes and Needs in Care across 11 countries for the years 2016-2017 (or nearest): Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.

Principal findings

The hip sample across ranged from 1859 patients in Aragon, Spain, to 42,849 in France. Mean age ranged from 81.2 in Switzerland to 84.7 in Australia, and the majority of hip patients across countries were female. The congestive heart failure (CHF) sample ranged from 742 patients in England to 21,803 in the United States. Mean age ranged from 77.2 in the United States to 80.3 in Sweden, and the majority of CHF patients were males. Average in-hospital mortality across countries was 4.1%. for the hip persona and 6.3% for the CHF persona. At the year mark, the mean mortality across all countries was 25.3% for the hip persona and 32.7% for CHF persona. Across both patient types, England reported the highest mortality at 1 year followed by the United States. Readmission rates for all periods were higher for the CHF persona than the hip persona. At 30 days, the average readmission rate for the hip persona was 13.8% and 27.6% for the CHF persona.

Conclusion

Across 11 countries, there are meaningful differences in health system outcomes for two types of patients.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/152350