Differences in health outcomes for high-need high-cost patients across high-income countries.
Aged
Aged, 80 and over
Australia
Developed Countries
/ statistics & numerical data
Diabetes Mellitus
/ economics
Europe
Female
Frail Elderly
/ statistics & numerical data
Heart Failure
/ economics
Hip Fractures
/ economics
Hospital Mortality
/ trends
Humans
Male
North America
Outcome Assessment, Health Care
/ economics
Patient Readmission
/ statistics & numerical data
health systems
mortality
readmissions
Journal
Health services research
ISSN: 1475-6773
Titre abrégé: Health Serv Res
Pays: United States
ID NLM: 0053006
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
06
07
2021
received:
15
03
2021
accepted:
12
07
2021
pubmed:
12
8
2021
medline:
15
12
2021
entrez:
11
8
2021
Statut:
ppublish
Résumé
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. We used individual-level patient data from 11 health systems. 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 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. 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. Across 11 countries, there are meaningful differences in health system outcomes for two types of patients.
Identifiants
pubmed: 34378796
doi: 10.1111/1475-6773.13735
pmc: PMC8579207
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1347-1357Informations de copyright
© 2021 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust.
Références
Health Policy. 2013 Sep;112(1-2):100-9
pubmed: 23680074
Health Econ. 2012 Aug;21 Suppl 2:1-5
pubmed: 22815107
Health Serv Res. 2021 Dec;56 Suppl 3:1335-1346
pubmed: 34390254
CMAJ. 2014 Jan 7;186(1):E52-60
pubmed: 24246589
Arch Osteoporos. 2021 Feb 23;16(1):40
pubmed: 33624180
Med Care. 2015 Aug;53(8):686-91
pubmed: 26172938
JAMA Cardiol. 2019 May 1;4(5):444-453
pubmed: 30969316
Bone. 2014 Sep;66:171-7
pubmed: 24933345
Health Econ. 2015 Dec;24 Suppl 2:116-39
pubmed: 26633872
PLoS One. 2020 Feb 6;15(2):e0228425
pubmed: 32027676
Health Serv Res. 2021 Dec;56 Suppl 3:1347-1357
pubmed: 34378796
Bull World Health Organ. 2000;78(6):717-31
pubmed: 10916909
CMAJ. 2010 Oct 19;182(15):1609-16
pubmed: 20837683
Health Econ. 2008 Jan;17(1 Suppl):S1-8
pubmed: 18186039
Orthop Surg. 2020 Apr;12(2):457-462
pubmed: 32167674
Eur J Neurol. 2015 Feb;22(2):284-91, e25-6
pubmed: 25196190
Eur J Health Econ. 2005 Dec;Suppl:2-10
pubmed: 16270212
Eur J Public Health. 2015 Feb;25 Suppl 1:3-7
pubmed: 25690123
Eur J Public Health. 2015 Feb;25 Suppl 1:35-43
pubmed: 25690128
Health Serv Res. 2020 Apr;55(2):249-258
pubmed: 31984494
J Health Econ. 2013 Sep;32(5):909-21
pubmed: 23938273