Have a personal or library account? Click to login
Toward Adoption of Health Risk Assessment in Population-Based and Clinical Scenarios: Lessons From JADECARE Cover

Toward Adoption of Health Risk Assessment in Population-Based and Clinical Scenarios: Lessons From JADECARE

International Journal of Integrated Care
Volume 24 (2024): Issue 2
By: Ruben Gonzalez-Colom,  David Monterde,  Roberta Papa,  Mart Kull,  Andres Anier,  Francesco Balducci,  Isaac Cano,  Marc Coca,  Marco De Marco,  Giulia Franceschini,  Saima Hinno,  Marco Pompili,  Emili Vela,  Jordi Piera-Jiménez,  Pol Pérez,  Josep Roca and  on behalf of the JADECARE consortium  
Open Access
|Jun 2024

References

  1. 1Dueñas-Espin 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 1; 6(4): e010301. DOI: 10.1136/bmjopen-2015-010301
    Back to article
  2. 2Cano I, Dueñas-Espín I, Hernandez C, De Batlle J, Benavent J, Contel JC, et al. Protocol for regional implementation of community-based collaborative management of complex chronic patients. npj Prim Care Respir Med. 2017; 27(1): 1–6. DOI: 10.1038/s41533-017-0043-9
    Back to article
  3. 3Brilleman SL, Gravelle H, Hollinghurst S, Purdy S, Salisbury C, Windmeijer F. Keep it simple? Predicting primary health care costs with clinical morbidity measures. J Health Econ. 2014; 35: 109–22. DOI: 10.1016/j.jhealeco.2014.02.005
    Back to article
  4. 4Calvo M, González R, Seijas N, Vela E, Hernández C, Batiste G, et al. Health outcomes from home hospitalization: Multisource predictive modeling. J Med Internet Res. 2020 Oct 1; 22(10): e21367. DOI: 10.2196/21367
    Back to article
  5. 5González-Colom R, Herranz C, Vela E, Monterde D, Contel J, Sisó-Almirall A, Piera-Jiménez J, Roca J, Cano I. Prevention of Unplanned Hospital Admissions in Multimorbid Patients Using Computational Modeling: Observational Retrospective Cohort Study. J Med Internet Res. 2023; 25: e40846. https://www.jmir.org/2023/1/e40846. DOI: 10.2196/40846
    Back to article
  6. 6Smith MA, Adelaine S, Bednarz L, Patterson BW, Pothof J, Liao F. Predictive Solutions in Learning Health Systems: The Critical Need to Systematize Implementation of Prediction to Action to Intervention. NEJM Catal Innov Care Deliv. 2021 Apr 21; 2(5). DOI: 10.1056/CAT.20.0650
    Back to article
  7. 7Bjerring JC, Busch J. Artificial Intelligence and Patient-Centered Decision-Making. Philos Technol. 2021; 34: 349–71. DOI: 10.1007/s13347-019-00391-6
    Back to article
  8. 8He J, Baxter SL, Xu J, Xu J, Zhou X, Zhang K. The practical implementation of artificial intelligence technologies in medicine. Nat Med. 2019; 25(30–36). DOI: 10.1038/s41591-018-0307-0
    Back to article
  9. 9Topol EJ. High-performance medicine: the convergence of human and artificial intelligence. Nat Med. 2019; 25: 44–56. DOI: 10.1038/s41591-018-0300-7
    Back to article
  10. 10Orlowski A, Snow S, Humphreys H, Smith W, Jones RS, Ashton R, et al. Bridging the impactibility gap in population health management: a systematic review. BMJ Open. 2021; 11: 52455. DOI: 10.1136/bmjopen-2021-052455
    Back to article
  11. 11Mora J, Iturralde MD, Prieto L, Domingo C, Gagnon MP, Martínez-Carazo C, et al. Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study. BMC Health Serv Res. 2017; 17(1): 1–8. DOI: 10.1186/s12913-017-2275-3
    Back to article
  12. 12JADECARE (2020–2023). Joint Action on implementation of digitally enabled integrated person-centred care [Internet]; 2020. Available from: https://www.jadecare.eu/.
    Back to article
  13. 13Department of Health. Goverment of Catalonia Health plan 2011–2015 [Internet]; 2011. Available from: https://scientiasalut.gencat.cat/handle/11351/5519.
    Back to article
  14. 143M™ Clinical Risk Groups (CRGs) | 3M [Internet]. [cited 2023 Apr 24]. Available from: https://www.3m.com/3M/en_US/health-information-systems-us/drive-value-based-care/patient-classification-methodologies/crgs/.
    Back to article
  15. 15Santaeugènia SJ, Contel JC, Vela E, Cleries M, Amil P, Melendo-Azuela EM, et al. 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. Int J Environ Res Public Heal. 2021 Sep; 18(18): 9473. DOI: 10.3390/ijerph18189473
    Back to article
  16. 16Constante Beitia C. The Health Plan for Catalonia: an instrument to transform the health system. Med Clin (Barc). 2015 Nov 1; 145 Suppl: 20–6. DOI: 10.1016/S0025-7753(15)30033-6
    Back to article
  17. 17Monterde D, Vela E, Clèries M. Adjusted morbidity groups: A new multiple morbidity measurement of use in Primary Care. Aten primaria. 2016 Dec 1; 48(10): 674–82. DOI: 10.1016/j.aprim.2016.06.003
    Back to article
  18. 18Monterde D, Vela E, Clèries M, García Eroles L, Pérez Sust P. Validity of adjusted morbidity groups with respect to clinical risk groups in the field of primary care. Aten Primaria. 2018 Feb 9; 51(3): 153–61. DOI: 10.1016/j.aprim.2017.09.012
    Back to article
  19. 19Ministerio de Sanidad Consumo y Bienestar Social. Informe del proyecto de Estratificación de la Población por Grupos de Morbilidad Ajustados (GMA) en el Sistema Nacional de Salud (2014–2016). Sistema Nacional de Salud; 2018.
    Back to article
  20. 20Catalan Health System Observatory. Results Centre [Internet]; 2023 [cited 2023 Jun 8]. Available from: https://observatorisalut.gencat.cat/en/central_de_resultats/index.html.
    Back to article
  21. 21Catalan Health Department. Shared Clinical History in Catalonia [Internet]. [cited 2023 Jun 16]. Available from: https://salutweb.gencat.cat/ca/ambits_actuacio/linies_dactuacio/tic/sistemes-informacio/gestio-assistencial/hc3/index.html#googtrans(ca%7Cen).
    Back to article
  22. 22Department of Health. Goverment of Catalonia Health plan for 2016–2020 [Internet]; 2016. Available from: https://scientiasalut.gencat.cat/handle/11351/4040?locale-attribute=en.
    Back to article
  23. 23Marin-Gomez FX, Mendioroz-Peña J, Mayer MA, Méndez-Boo L, Mora N, Hermosilla E, et al. Comparing the clinical characteristics and mortality of residential and non-residential older people with COVID-19: Retrospective observational study. Int J Environ Res Public Health. 2022 Jan 1; 19(1): 483. DOI: 10.3390/ijerph19010483
    Back to article
  24. 24Roso-Llorach A, Serra-Picamal X, Cos FX, Pallejà-Millán M, Mateu L, Rosell A, et al. Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain. Glob Epidemiol. 2022 Dec 1; 4: 100071. DOI: 10.1016/j.gloepi.2022.100071
    Back to article
  25. 25Monterde D, Vela E, Clèries M, Garcia-Eroles L, Roca J, Pérez-Sust P. Multimorbidity as a predictor of health service utilization in primary care: a registry-based study of the Catalan population. BMC Fam Pract. 2020 Feb 17; 21(1): 1–9. DOI: 10.1186/s12875-020-01104-1
    Back to article
  26. 26Vela E, Piera-Jiménez J. Performance of Quantitative Measures of Multimorbidity: A Population-Based Retrospective Analysis; 2021 Mar 1. DOI: 10.1186/s12889-021-11922-2
    Back to article
  27. 27Barrio-Cortes J, Castaño-Reguillo A, Beca-Martínez MT, Bandeira-de Oliveira M, López-Rodríguez C, Jaime-Sisó MÁ. Chronic diseases in the geriatric population: morbidity and use of primary care services according to risk level. BMC Geriatr. 2021 Dec 1; 21(1): 1–11. DOI: 10.1186/s12877-021-02217-7
    Back to article
  28. 28Barrio-Cortes J, Soria-Ruiz-Ogarrio M, Martínez-Cuevas M, Castaño-Reguillo A, Bandeira-de Oliveira M, Beca-Martínez MT, et al. Use of primary and hospital care health services by chronic patients according to risk level by adjusted morbidity groups. BMC Health Serv Res. 2021 Dec 1; 21(1): 1–13. DOI: 10.1186/s12913-021-07020-z
    Back to article
  29. 29Vela E, Tényi Á, Cano I, Monterde D, Cleries M, Garcia-Altes A, et al. Population-based analysis of patients with COPD in Catalonia: a cohort study with implications for clinical management. BMJ Open. 2018 Mar 1; 8(3): e017283. DOI: 10.1136/bmjopen-2017-017283
    Back to article
  30. 30Department of Health. Generalitat de Catalunya. The Catalan Information Systems Master Plan Building a digital health strategy for Catalonia together [Internet]; 2019 [cited 2023 May 2]. Available from: https://catsalut.gencat.cat/web/.content/minisite/catsalut/actualitat/2021/documents/2021-05-14-The-Catalan-Information-System-Master-Plan.pdf.
    Back to article
  31. 31Monterde D, Cainzos-Achirica M, Cossio-Gil Y, García-Eroles L, Pérez-Sust P, Arrufat M, et al. Performance of Comprehensive Risk Adjustment for the Prediction of In-Hospital Events Using Administrative Healthcare Data: The Queralt Indices. Risk Manag Healthc Policy. 2020; 13: 271. DOI: 10.2147/RMHP.S228415
    Back to article
  32. 32Monterde D, Carot-Sans G, Cainzos-Achirica M, Abilleira S, Coca M, Vela E, et al. Performance of Three Measures of Comorbidity in Predicting Critical COVID-19: A Retrospective Analysis of 4607 Hospitalized Patients; 2021. DOI: 10.2147/RMHP.S326132
    Back to article
  33. 33Goldfield N. The evolution of diagnosis-related groups (DRGs): From its beginnings in case-mix and resource use theory, to its implementation for payment and now for its current utilization for quality within and outside the hospital. Qual Manag Health Care. 2010 Jan; 19(1): 3–16. DOI: 10.1097/QMH.0b013e3181ccbcc3
    Back to article
  34. 34ICD-9-CM – International Classification of Diseases, Ninth Revision, Clinical Modification [Internet]. [cited 2023 May 28]. Available from: https://www.cdc.gov/nchs/icd/icd9cm.htm.
    Back to article
  35. 35ICD-10-CM – International Classification of Diseases, Tenth Revision, Clinical Modification [Internet]. [cited 2021 Jul 21]. Available from: https://www.cdc.gov/nchs/icd/icd10cm.htm.
    Back to article
  36. 36Kindig D. Health Affairs Forefront. 2015 [cited 2023 May 26]. What Are We Talking About When We Talk About Population Health? Available from: https://www.healthaffairs.org/content/forefront/we-talking-we-talk-population-health.
    Back to article
  37. 37Christoff P. Running PDSA cycles. Curr Probl Pediatr Adolesc Health Care. 2018 Aug 1; 48(8): 198–201. DOI: 10.1016/j.cppeds.2018.08.006
    Back to article
  38. 38Baltaxe E, Hsieh HW, Roca J, Cano I. The Assessment of Medical Device Software Supporting Health Care Services for Chronic Patients in a Tertiary Hospital: Overarching Study. J Med Internet Res. 2023 Jan 4; 25(1): e40976. https//www.jmir.org/2023/1/e40976.
    Back to article
  39. 39Herranz C, Martín L, Dana F, Sisó-Almirall A, Roca J, Cano I. Health Circuit: a practice-proven adaptive case management approach for innovative healthcare services. medRxiv. 2023 Mar 28. DOI: 10.1101/2023.03.22.23287569
    Back to article
  40. 40Bansback N, Bell M, Spooner L, Pompeo A, Han PKJ, Harrison M. Communicating Uncertainty in Benefits and Harms: A Review of Patient Decision Support Interventions. Patient. 2017 Jun 1; 10(3): 311–9. DOI: 10.1007/s40271-016-0210-z
    Back to article
  41. 41Civita M, Roman R. PADRIS, una eina per a la millora dels processos assistencials, la recerca biomèdica i la planificació sanitària. Scientia; 2019. https://hdl.handle.net/11351/3887
    Back to article
  42. 42Murray SA, Kendall M, Boyd K, Sheikh A. Illness trajectories and palliative care. BMJ. 2005 Apr 28; 330(7498): 1007–11. DOI: 10.1136/bmj.330.7498.1007
    Back to article
  43. 43Jensen AB, Moseley PL, Oprea TI, Ellesøe SG, Eriksson R, Schmock H, et al. Temporal disease trajectories condensed from population-wide registry data covering 6.2 million patients. Nat Commun. 2014 Jun 24; 5(1): 1–10. DOI: 10.1038/ncomms5022
    Back to article
  44. 44González-Colom R, Mitra K, Vela E, Gezsi A, Paajanen T, Gal Z, et al. Multicentric assessment of a Multimorbidity Adjusted Disability Score to stratify depression-related risks using temporal disease maps. medRxiv. 2023 Jan 1. DOI: 10.1101/2023.09.04.23295005
    Back to article
DOI: https://doi.org/10.5334/ijic.7701 | Journal eISSN: 1568-4156
Journal RSS Feed
Language: English
Submitted on: Jul 6, 2023
Accepted on: May 21, 2024
Published on: Jun 4, 2024
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
health risk assessment,
adjusted morbidity groups,
integrated care,
predictive modelling

© 2024 Ruben Gonzalez-Colom, David Monterde, Roberta Papa, Mart Kull, Andres Anier, Francesco Balducci, Isaac Cano, Marc Coca, Marco De Marco, Giulia Franceschini, Saima Hinno, Marco Pompili, Emili Vela, Jordi Piera-Jiménez, Pol Pérez, Josep Roca, on behalf of the JADECARE consortium, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Previous articleVolume 24 (2024): Issue 2Next article