Proposals for enhanced health risk assessment and stratification in an integrated care scenario

Dueñas-Espín, Iván, 1979-; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Clèries, Montse; Contel, Joan Carles; Manuel Keenoy, Esteban de; García Aymerich, Judith; Gomez Cabrero, David; Kaye, Rachelle; Lahr, Maarten M. H.; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Stork, Stefan; Tegnér, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca Torrent, Josep

Proposals for enhanced health risk assessment and stratification in an integrated care scenario

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dc.contributor.author Dueñas-Espín, Iván, 1979-ca
dc.contributor.author Vela, Emilica
dc.contributor.author Pauws, Steffenca
dc.contributor.author Bescos, Cristinaca
dc.contributor.author Cano, Isaacca
dc.contributor.author Clèries, Montseca
dc.contributor.author Contel, Joan Carlesca
dc.contributor.author Manuel Keenoy, Esteban deca
dc.contributor.author García Aymerich, Judithca
dc.contributor.author Gomez Cabrero, Davidca
dc.contributor.author Kaye, Rachelleca
dc.contributor.author Lahr, Maarten M. H.ca
dc.contributor.author Lluch-Ariet, Magíca
dc.contributor.author Moharra, Montserratca
dc.contributor.author Monterde, Davidca
dc.contributor.author Mora, Joanaca
dc.contributor.author Nalin, Marcoca
dc.contributor.author Pavlickova, Andreaca
dc.contributor.author Piera, Jordica
dc.contributor.author Ponce, Saraca
dc.contributor.author Santaeugenia, Sebastiàca
dc.contributor.author Schonenberg, Helenca
dc.contributor.author Stork, Stefanca
dc.contributor.author Tegnér, Jesperca
dc.contributor.author Velickovski, Filipca
dc.contributor.author Westerteicher, Christophca
dc.contributor.author Roca Torrent, Josepca
dc.date.accessioned 2018-05-09T07:36:50Z
dc.date.available 2018-05-09T07:36:50Z
dc.date.issued 2016
dc.description.abstract OBJECTIVES: Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. SETTINGS: The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). PARTICIPANTS: Responsible teams for regional data management in the five ACT regions. PRIMARY AND SECONDARY OUTCOME MEASURES: We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. RESULTS: There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. CONCLUSIONS: The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require prospective evaluation.
dc.description.sponsorship Supported by ACT—Advancing Care Coordination and Telehealth Deployment programme (UE Grant number 20121209), PITES (FIS-PI12/01241) and Generalitat de Catalunya (2014SGR661)
dc.format.mimetype application/pdf
dc.identifier.citation Dueñas-Espín I, Vela E, Pauws S, Bescos C, Cano I, Cleries M et al. Proposals for enhanced health risk assessment and stratification in an integrated care scenario. BMJ Open. 2016 Apr 15;6(4):e010301. DOI: 10.1136/bmjopen-2015-010301
dc.identifier.doi http://dx.doi.org/10.1136/bmjopen-2015-010301
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10230/34586
dc.language.iso eng
dc.publisher BMJ Publishing Groupca
dc.relation.ispartof BMJ Open. 2016 Apr 15;6(4):e010301
dc.rights © Ivan Dueñas-Espín et al. This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com [Creative Commons Attribution License or Creative Commons Attribution Non-Commercial License]
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
dc.subject.other Riscos per a la salut -- Avaluació
dc.subject.other Malalties cròniques
dc.title Proposals for enhanced health risk assessment and stratification in an integrated care scenarioca
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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