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Tytuł:
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Differences in health outcomes for high-need high-cost patients across high-income countries.
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Autorzy:
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Papanicolas I; Department of Health Policy, London School of Economics, London, UK.
Riley K; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Abiona O; Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Arvin M; Scientific Center for Quality of Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Atsma F; Scientific Center for Quality of Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Bernal-Delgado E; Institute for Health Sciences in Aragon (IACS), Zaragoza, Aragon, Spain.
Bowden N; Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand.
Blankart CR; KPM Center for Public Management, University of Bern, Bern, Switzerland.; Hamburg Center for Health Economics, Universität Hamburg, Hamburg, Germany.
Deeny S; The Health Foundation, London, UK.
Estupiñán-Romero F; Institute for Health Sciences in Aragon (IACS), Zaragoza, Aragon, Spain.
Gauld R; Otago Business School, University of Otago, Dunedin, Otago, New Zealand.
Haywood P; Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Janlov N; The Swedish Agency for Health and Care Services Analysis, Stockholm, Sweden.
Knight H; The Health Foundation, London, UK.
Lorenzoni L; Health Division, Organisation for Economic Co-operation and Development (OECD), Paris, France.
Marino A; Department of Health Policy, London School of Economics, London, UK.; Health Division, Organisation for Economic Co-operation and Development (OECD), Paris, France.
Or Z; Institute for Research and Documentation in Health Economics (IRDES), Paris, France.
Penneau A; Institute for Research and Documentation in Health Economics (IRDES), Paris, France.
Schoenfeld AJ; Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Shatrov K; KPM Center for Public Management, University of Bern, Bern, Switzerland.; Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
Stafford M; The Health Foundation, London, UK.
van de Galien O; Zilveren Kruis, Leusden, The Netherlands.
van Gool K; Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, Australia.
Wodchis W; Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Canada.
Jha AK; Brown School of Public Health, Providence, Rhode Island, USA.
Figueroa JF; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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Źródło:
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Health services research [Health Serv Res] 2021 Dec; Vol. 56 Suppl 3, pp. 1347-1357. Date of Electronic Publication: 2021 Aug 11.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Malden, MA : Blackwell
Original Publication: Chicago, Hospital Research and Educational Trust.
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MeSH Terms:
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Heart Failure*/economics
Heart Failure*/mortality
Heart Failure*/therapy
Hip Fractures*/economics
Hip Fractures*/rehabilitation
Hip Fractures*/surgery
Outcome Assessment, Health Care*/economics
Outcome Assessment, Health Care*/statistics & numerical data
Developed Countries/*statistics & numerical data
Hospital Mortality/*trends
Patient Readmission/*statistics & numerical data
Aged ; Aged, 80 and over ; Australia ; Diabetes Mellitus/economics ; Diabetes Mellitus/therapy ; Europe ; Female ; Frail Elderly/statistics & numerical data ; Humans ; Male ; North America
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References:
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Contributed Indexing:
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Keywords: health systems; mortality; readmissions
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Entry Date(s):
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Date Created: 20210811 Date Completed: 20211210 Latest Revision: 20240407
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Update Code:
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20240407
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PubMed Central ID:
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PMC8579207
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DOI:
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10.1111/1475-6773.13735
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PMID:
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34378796
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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.
(© 2021 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust.)
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