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Characteristics and Service Utilization by Complex Chronic and Advanced Chronic Patients in Catalonia: A Retrospective Seven-Year Cohort-Based Study of an Implemented Chronic Care Program

Author

Listed:
  • Sebastià J. Santaeugènia

    (Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain)

  • Joan C. Contel

    (Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain)

  • Emili Vela

    (Unitat d’Informació i Coneixement, Servei Català de la Salut, 08006 Barcelona, Spain
    Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, 08006 Barcelona, Spain)

  • Montserrat Cleries

    (Unitat d’Informació i Coneixement, Servei Català de la Salut, 08006 Barcelona, Spain
    Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, 08006 Barcelona, Spain)

  • Paloma Amil

    (Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain)

  • Eva M. Melendo-Azuela

    (Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain)

  • Esther Gil-Sánchez

    (Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain)

  • Victoria Mir

    (Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain)

  • Jordi Amblàs-Novellas

    (Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain
    Chronic Care Program, Department of Health, Generalitat de Catalunya, 08020 Barcelona, Spain
    Chair and Department of Palliative Care, University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Barcelona, Spain)

Abstract

The Chronic Care Program introduced in Catalonia in 2011 focuses on improving the identification and management of complex chronic (CCPs) and advanced chronic patients (ACPs) by implementing an individualized care model. Its first stage is their identification based on chronicity, difficult clinical management (i.e., complexity), and, in ACPs, limited life prognosis. Subsequent stages are individual evaluation and implementation of a shared personalized care plan. This retrospective study, including all CCPs and ACPs identified in Catalonia between 2013 and 2019, was aimed at describing the characteristics and healthcare service utilization among these patients. Data were obtained from an administrative database and included sociodemographic, clinical, and service utilization variables and morbidity-associated risk according to the Adjusted Morbidity Groups (GMA) stratification. During the study period, CCPs’ and ACPs’ prevalence increased and was higher in lower-income populations; most cases were women. CCPs and ACPs had all comorbidities at higher frequencies, higher utilization of healthcare services, and were more frequently at high risk (63% and 71%, respectively) than age-, sex-, and income level-adjusted non-CCP (23%) and non-ACP populations (30%). These results show effective identification of the program’s target population and demonstrate that CCPs and ACPs have a higher burden of multimorbidity and healthcare needs.

Suggested Citation

  • Sebastià J. Santaeugènia & Joan C. Contel & Emili Vela & Montserrat Cleries & Paloma Amil & Eva M. Melendo-Azuela & Esther Gil-Sánchez & Victoria Mir & Jordi Amblàs-Novellas, 2021. "Characteristics and Service Utilization by Complex Chronic and Advanced Chronic Patients in Catalonia: A Retrospective Seven-Year Cohort-Based Study of an Implemented Chronic Care Program," IJERPH, MDPI, vol. 18(18), pages 1-20, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:18:p:9473-:d:631388
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    References listed on IDEAS

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    1. Junqiang Zhang & Liangqiang Li & Yu Qian, 2016. "A Study of Online Review Promptness in a B2C System," Discrete Dynamics in Nature and Society, Hindawi, vol. 2016, pages 1-10, July.
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    Cited by:

    1. Mariona Espaulella-Ferrer & Nuria Molist-Brunet & Joan Espaulella-Panicot & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Marta Otero-Viñas, 2023. "Medication Assessment in an Older Population during Acute Care Hospitalization and Its Effect on the Anticholinergic Burden: A Prospective Cohort Study," IJERPH, MDPI, vol. 20(7), pages 1-13, March.
    2. Xavier Busquet-Duran & Eduard Moreno-Gabriel & Eva Maria Jiménez-Zafra & Magda Tura-Poma & Olga Bosch-DelaRosa & Anna Moragas-Roca & Susana Martin-Moreno & Emilio Martínez-Losada & Silvia Crespo-Ramír, 2021. "Gender and Observed Complexity in Palliative Home Care: A Prospective Multicentre Study Using the HexCom Model," IJERPH, MDPI, vol. 18(23), pages 1-11, November.
    3. Carolina Burgos Díez & Rosa Maria Sequera Requero & Jose Ferrer Costa & Francisco José Tarazona-Santabalbina & Marià Monzó Planella & Cristina Cunha-Pérez & Sebastià Josep Santaeugènia González & Grup, 2022. "Study of a Quasi-Experimental Trial to Compare Two Models of Home Care for the Elderly in an Urban Primary Care Setting in Spain: Results of Intermediate Analysis," IJERPH, MDPI, vol. 19(4), pages 1-14, February.

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