Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans Affairs Health Care System

BMJ Open

Volumn 5, Issue 4, 2015, Pages

  Zulman, Donna M ^a,b   Chee, Christine Pal ^a   Wagner, Todd H ^a,b   Yoon, Jean ^a   Cohen, Danielle M ^b   Holmes, Tyson H ^b   Ritchie, Christine ^c,d   Asch, Steven M ^a,b  

^a VA PALO ALTO HEALTH CARE SYSTEM   (United States)

^b STANFORD UNIVERSITY   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

^d VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGE; AGED; ARTICLE; CHRONIC DISEASE; CROSS-SECTIONAL STUDY; DEPRESSION; EMERGENCY WARD; ENDOCRINE DISEASE; ETHNIC OR RACIAL ASPECTS; FEMALE; HEALTH CARE COST; HEALTH CARE SYSTEM; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HEALTH SERVICE; HOMELESSNESS; HOSPITAL DEPARTMENT; HOSPITALIZATION COST; HUMAN; HYPERTENSION; ISCHEMIC HEART DISEASE; MAJOR CLINICAL STUDY; MALE; MALIGNANT NEOPLASTIC DISEASE; MARRIAGE; MENTAL DISEASE; MORBIDITY; MULTIMORBIDITY; MUSCULOSKELETAL DISEASE; OUTPATIENT CARE; RETROSPECTIVE STUDY; SCHIZOPHRENIA; SEX DIFFERENCE; COMORBIDITY; ECONOMICS; GOVERNMENT; INTEGRATED HEALTH CARE SYSTEM; MIDDLE AGED; PATIENT ATTITUDE; PREVALENCE; PUBLIC HOSPITAL; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA; UNITED STATES; UTILIZATION; VERY ELDERLY; VETERANS HEALTH;

ADULT; AGED; AGED, 80 AND OVER; CHRONIC DISEASE; COMORBIDITY; CROSS-SECTIONAL STUDIES; DELIVERY OF HEALTH CARE, INTEGRATED; FEMALE; HEALTH CARE COSTS; HOSPITALS, VETERANS; HUMANS; LINEAR MODELS; MALE; MIDDLE AGED; PATIENT ACCEPTANCE OF HEALTH CARE; PREVALENCE; RETROSPECTIVE STUDIES; UNITED STATES; UNITED STATES DEPARTMENT OF VETERANS AFFAIRS; VETERANS HEALTH;

EID: 84929339063     PISSN: None     EISSN: 20446055     Source Type: Journal    
DOI: 10.1136/bmjopen-2015-007771     Document Type: Article

References (35)

1. Cohen S, Uberoi N. Differentials in the concentration in the level of health expenditures across population subgroups in the U.S., 2010. Rockville, MD: Agency for Healthcare Research and Quality Statistical Brief #421, 2013. http://meps.ahrq.gov/mepsweb/data-files/publications/st421/stat421.shtml (accessed 22 Jan 15).
2. Joynt K, Gawande AA, Orav E, et al. Contribution of preventable acute care spending to total spending for high-cost Medicare patients. JAMA 2013;309:2572-8.
3. Sommers A, Cohen M. Medicaid's High Cost Enrollees: How Much Do They Drive Program Spending? Washington, DC: Kaiser Commission for Medicaid and the Uninsured, 2006.
4. Garber AM, MaCurdy TE, McClellan MB. Persistence of Medicare expenditures among elderly beneficiaries. In: Garber AM, ed. Frontiers in Health Policy Research. Vol 1. Cambridge, MA: MIT, 1998:153-80.
5. Cohen S, Yu W. AHRQ Statistical Brief #354: The concentration and persistence in the level of health expenditures over time: Estimates for the US population, 2008-2009. 2012. http://meps.ahrq.gov/mepsweb/data-files/publications/st354/stat354.pdf (accessed 28 Nov 2012).
6. Coughlin T, Long S. Health care spending and service use among high-cost Medicaid beneficiaries, 2002-2004. Inquiry 2009;46:405-17.
7. Hasselman D. Super-Utilizer Summit: Common Themes from Innovative Complex Care Management Programs. Hamilton, NJ: Center for Health Care Strategies, Inc., 2013.
8. Kronick RG, Bella M, Gilmer TP, et al. The Faces of Medicaid II: recognizing the care needs of people with multiple chronic conditions. Center for Health Care Strategies, Inc., 2007.
9. Powers BW, Chaguturu SK, Ferris TG. Optimizing high-risk care management. JAMA 2015;313:795-6.
10. Centers for Medicare and Medicaid Services. Chronic Conditions among Medicare Beneficiaries. Chartbook: 2012 Edition. http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trendsand-Reports/Chronic-Conditions/Downloads/2012Chartbook.pdf (accessed 2 Apr 2015).
11. Kizer KW, Dudley RA. Extreme makeover: transformation of the veterans health care system. Annu Rev Public Health 2009;30:313-39.
12. Asch SM, McGlynn EA, Hogan MM, et al. Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample. Ann Intern Med 2004;141:938-45.
13. Phibbs CS, Bhandari A, Yu W, et al. Estimating the costs of VA ambulatory care. Med Care Res Rev 2003;60(3 Suppl):54-73.
14. Wagner TH, Chen S, Barnett PG. Using average cost methods to estimate encounter-level costs for medical-surgical stays in the VA. Med Care Res Rev 2003;60(3 Suppl):15S-36S.
15. Yu W, Wagner TH, Chen S, et al. Average cost of VA rehabilitation, mental health, and long-term hospital stays. Med Care Res Rev 2003;60(3 Suppl):40S-53S.
16. Yoon J, Scott J, Phibbs CS, et al. Recent trends in Veterans Affairs chronic condition spending. Popul Health Manag 2011;14:293-8.
17. Demakis J, McQueen L, Kizer K, et al. Quality Enhancement Research Initiative (QUERI): a collaboration between research and clinical practice. Med Care 2000;38(6 Suppl 1):I17-25.
18. Yu W, Ravelo A, Wagner TH, et al. Prevalence and costs of chronic conditions in the VA health care system. Med Care Res Rev 2003;60(3 Suppl):146S-67S.
19. Yoon J, Zulman D, Scott JY, et al. Costs associated with multimorbidity among VA patients. Med Care 2014;52(Suppl 3):S31-6.
20. Agency for Healthcare Research and Quality. HCUP Chronic Condition Indicator. Healthcare Cost and Utilization Project (HCUP). 2011. http://www.hcup-us.ahrq.gov/toolssoftware/chronic/chronic.jsp (accessed 17 Jul 2013).
21. Steinman MA, Lee SJ, Boscardin WJ, et al. Patterns of multimorbidity in elderly veterans. J Am Geriatr Soc 2012;60:1872-80.
22. Papke LE, Wooldridge JM. Econometric methods for fractional response variables with an application to 401 (K) plan participation rates. J Appl Econ 1996;11:619-32.
23. Smith S, Soubhi H, Fortin M, et al. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database Syst Rev 2012;4:CD006560.
24. Grant RW, Adams AS, Bayliss EA, et al. Establishing visit priorities for complex patients: a summary of the literature and conceptual model to guide innovative interventions. Healthcare 2013;1:117-22.
25. Guiding Principles for the Care of Older Adults with Multimorbidity: An Approach for Clinicians. American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc 2012;60:E1-25.
26. Peterson D, Helfand M, Humphrey L, et al. Evidence Brief: Effectiveness of Intensive Primary Care Programs, VA-ESP Project #09-199. 2012.
27. Brown RS, Peikes D, Peterson G, et al. Six features of Medicare coordinated care demonstration programs that cut hospital admissions of high-risk patients. Health Affairs (Project Hope) 2012;31:1156-66.
28. Boyd C, Leff B, Weiss C, et al. Clarifying multimorbidity patterns to improve targeting and delivery of clinical services for Medicaid populations. Center for Health Care Strategies, Inc., 2010.
29. Hutter N, Schnurr A, Baumeister H. Healthcare costs in patients with diabetes mellitus and comorbid mental disorders-a systematic review. Diabetologia 2010;53:2470-9.
30. Molosankwe I, Patel A, Jose Gagliardino J, et al. Economic aspects of the association between diabetes and depression: a systematic review. J Affect Disord 2012;142(Suppl):S42-55.
31. Hutter N, Knecht A, Baumeister H. Health: care costs in persons with asthma and comorbid mental disorders: a systematic review. Gen Hosp Psychiatry 2011;33:443-53.
32. Yohannes AM, Willgoss TG, Baldwin RC, et al. Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. Int J Geriatric Psychiatry 2010;25:1209-21.
33. Medicare Payment Advisory Commission. Issues for risk adjustment in Medicare Advantage. Report to Congress: Medicare and the Health Care Delivery System. Washington, DC, 2012.
34. Chapko MK, Liu CF, Perkins M, et al. Equivalence of two healthcare costing methods: bottom-up and top-down. Health Econ 2009;18:1188-201.
35. Newcomer R, Clay T, Luxenberg JS, et al. Misclassification and selection bias when identifying Alzheimer's disease solely from Medicare claims records. J Am Geriatr Soc 1999;47:215-19.