A cluster-based approach for integrating clinical management of Medicare beneficiaries with multiple chronic conditions.

ABSTRACT:

Background

Approximately 28% of adults have ≥3 chronic conditions (CCs), accounting for two-thirds of U.S. healthcare costs, and often having suboptimal outcomes. Despite Institute of Medicine recommendations in 2001 to integrate guidelines for multiple CCs, progress is minimal. The vast number of unique combinations of CCs may limit progress.

Methods and findings

To determine whether major CCs segregate differentially in limited groups, electronic health record and Medicare paid claims data were examined in one accountable care organization with 44,645 Medicare beneficiaries continuously enrolled throughout 2015. CCs predicting clinical outcomes were obtained from diagnostic codes. Agglomerative hierarchical clustering defined 13 groups having similar within group patterns

SUBMITTER: Egan BM 

PROVIDER: S-EPMC6584004 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature