Prediction Models for Future High-Need High-Cost Healthcare Use: a Systematic Review.
العنوان: | Prediction Models for Future High-Need High-Cost Healthcare Use: a Systematic Review. |
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المؤلفون: | de Ruijter UW; Section of Medical Decision Making, Department of Public Health, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands.; Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands., Kaplan ZLR; Section of Medical Decision Making, Department of Public Health, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands. z.kaplan@erasmusmc.nl., Bramer WM; Medical Library, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Eijkenaar F; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands., Nieboer D; Section of Medical Decision Making, Department of Public Health, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands., van der Heide A; Section of Care at the End of Life, Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Lingsma HF; Section of Medical Decision Making, Department of Public Health, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands., Bax WA; Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands. |
المصدر: | Journal of general internal medicine [J Gen Intern Med] 2022 May; Vol. 37 (7), pp. 1763-1770. Date of Electronic Publication: 2022 Jan 11. |
نوع المنشور: | Systematic Review |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Secaucus, NJ : Springer Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986- |
مواضيع طبية MeSH: | Delivery of Health Care* , Health Services Needs and Demand*, Adult ; Bias ; Cost-Benefit Analysis ; Humans ; Models, Theoretical ; Prognosis ; Risk Assessment |
مستخلص: | Background: In an effort to improve both quality of care and cost-effectiveness, various care-management programmes have been developed for high-need high-cost (HNHC) patients. Early identification of patients at risk of becoming HNHC (i.e. case finding) is crucial to a programme's success. We aim to systematically identify prediction models predicting future HNHC healthcare use in adults, to describe their predictive performance and to assess their applicability. Methods: Ovid MEDLINE® All, EMBASE, CINAHL, Web of Science and Google Scholar were systematically searched from inception through January 31, 2021. Risk of bias and methodological quality assessment was performed through the Prediction model Risk Of Bias Assessment Tool (PROBAST). Results: Of 5890 studies, 60 studies met inclusion criteria. Within these studies, 313 unique models were presented using a median development cohort size of 20,248 patients (IQR 5601-174,242). Predictors were derived from a combination of data sources, most often claims data (n = 37; 62%) and patient survey data (n = 29; 48%). Most studies (n = 36; 60%) estimated patients' risk to become part of some top percentage of the cost distribution (top-1-20%) within a mean time horizon of 16 months (range 12-60). Five studies (8%) predicted HNHC persistence over multiple years. Model validation was performed in 45 studies (76%). Model performance in terms of both calibration and discrimination was reported in 14 studies (23%). Overall risk of bias was rated as 'high' in 40 studies (67%), mostly due to a 'high' risk of bias in the subdomain 'Analysis' (n = 37; 62%). Discussion: This is the first systematic review (PROSPERO CRD42020164734) of non-proprietary prognostic models predicting HNHC healthcare use. Meta-analysis was not possible due to heterogeneity. Most identified models estimated a patient's risk to incur high healthcare expenditure during the subsequent year. However, case-finding strategies for HNHC care-management programmes are best informed by a model predicting HNHC persistence. Therefore, future studies should not only focus on validating and extending existing models, but also concentrate on clinical usefulness. (© 2022. The Author(s).) |
References: | PLoS One. 2019 Jun 19;14(6):e0217353. (PMID: 31216286) N Engl J Med. 2016 Sep 8;375(10):909-11. (PMID: 27602661) Health Aff (Millwood). 2015 Aug;34(8):1312-9. (PMID: 26240244) Health Serv Res. 2001 Dec;36(6 Pt 2):194-206. (PMID: 16148969) Epidemiology. 2004 Sep;15(5):615-25. (PMID: 15308962) BMJ Open. 2018 May 31;8(5):e019830. (PMID: 29858409) Am J Manag Care. 2015 Oct 01;21(10):e576-82. (PMID: 26619059) Am J Prev Med. 2015 Aug;49(2):161-71. (PMID: 25960393) J Hosp Med. 2013 Dec;8(12):665-71. (PMID: 24173680) Ann Intern Med. 2004 Oct 5;141(7):533-6. (PMID: 15466770) Epidemiology. 2010 Jan;21(1):128-38. (PMID: 20010215) BMJ Open. 2020 Jan 6;10(1):e031622. (PMID: 31911514) Syst Rev. 2021 Jan 26;10(1):39. (PMID: 33499930) NPJ Digit Med. 2020 Nov 11;3(1):148. (PMID: 33299137) Ann Intern Med. 2019 Jan 1;170(1):51-58. (PMID: 30596875) J Clin Epidemiol. 2019 Nov;115:64-76. (PMID: 31295514) Healthcare (Basel). 2020 Dec 04;8(4):. (PMID: 33291559) Health Serv Res. 2014 Dec;49 Suppl 2:2147-72. (PMID: 25130916) JAMA. 2015 Sep 8;314(10):1063-4. (PMID: 26348755) BMC Med Res Methodol. 2016 Nov 24;16(1):163. (PMID: 27881078) Popul Health Manag. 2011 Aug;14(4):205-10. (PMID: 21241172) BMJ Open. 2018 Sep 8;8(9):e023113. (PMID: 30196269) Popul Health Manag. 2021 Jun;24(3):393-402. (PMID: 32941105) Eur Heart J. 2014 Aug 1;35(29):1925-31. (PMID: 24898551) J Health Soc Behav. 1995 Mar;36(1):1-10. (PMID: 7738325) Am J Med. 2017 May;130(5):601.e17-601.e22. (PMID: 28065773) BMJ Open. 2017 Jan 11;7(1):e011580. (PMID: 28077408) BMC Health Serv Res. 2018 Jan 30;18(1):65. (PMID: 29382327) Milbank Mem Fund Q Health Soc. 1973 Winter;51(1):95-124. (PMID: 4198894) Prev Chronic Dis. 2015 Nov 12;12:E197. (PMID: 26564013) Issue Brief (Commonw Fund). 2015 Oct;31:1-19. (PMID: 26591906) Int J Qual Health Care. 2005 Apr;17(2):141-6. (PMID: 15665066) BMJ Open. 2017 Nov 12;7(11):e017775. (PMID: 29133323) Health Aff (Millwood). 2012 Jun;31(6):1156-66. (PMID: 22665827) Health Care Manag Sci. 2014 Sep;17(3):284-301. (PMID: 23780751) J Am Geriatr Soc. 2018 May;66(5):1002-1008. (PMID: 29427509) JAMA. 2015 Jan 27;313(4):409-10. (PMID: 25626037) BMC Med Res Methodol. 2012 Feb 29;12:21. (PMID: 22375553) Healthc Policy. 2014 Feb;9(3):68-79. (PMID: 24726075) Med Care. 2018 Oct;56(10):e61-e69. (PMID: 29189576) J Clin Epidemiol. 1996 Dec;49(12):1373-9. (PMID: 8970487) Am J Manag Care. 2013 Sep;19(9):725-32. (PMID: 24304255) Issue Brief (Commonw Fund). 2014 Aug;19:1-19. (PMID: 25115035) Int J Surg. 2010;8(5):336-41. (PMID: 20171303) |
فهرسة مساهمة: | Keywords: health expenditures; managed care programmes; meaningful use; patient care management; prognosis |
تواريخ الأحداث: | Date Created: 20220112 Date Completed: 20220526 Latest Revision: 20220808 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC9130365 |
DOI: | 10.1007/s11606-021-07333-z |
PMID: | 35018571 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1525-1497 |
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DOI: | 10.1007/s11606-021-07333-z |