Cluster-Based Approach for Integrating Clinical Management of Multiple Chronic Conditions

Principal Investigator(s): View help for Principal Investigator(s) Brent Egan, University of South Carolina, School of Medicine-Greenville; Susan Sutherland, University of South Carolina School of Medicine-Greenville

Version: View help for Version V1

Name	File Type	Size	Last Modified
ChronicConditionsData.xlsx	application/vnd.openxmlformats-officedocument.spreadsheetml.sheet	4.5 MB	04/03/2019 10:49:AM
Cluster-Data-Description.xlsx	application/vnd.openxmlformats-officedocument.spreadsheetml.sheet	18.4 KB	04/03/2019 10:48:AM
DemographicClusterData.xlsx	application/vnd.openxmlformats-officedocument.spreadsheetml.sheet	3 MB	04/03/2019 10:49:AM

Project Citation:

Egan, Brent, and Sutherland, Susan. Cluster-Based Approach for Integrating Clinical Management of Multiple Chronic Conditions. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2019-06-04. https://doi.org/10.3886/E109150V1

Project Description

Summary: Many adults have multiple chronic conditions and medical care is often fragmented despite the recognized need to develop integrated guidelines. We describe a cohort of 44,645 patients (mean age 72) with an average of 6 chronic conditions determined from retrospective medical records review. Agglomerative hierarchical clustering methods are used to identify thirteen homogenous groups of patients with regards to chronic conditions.Identifying groups of patients with similar profiles of chronic conditions can provide a framework in which to develop efficient, comprehensive clinical management guidelines.

Funding Sources: None

Scope of Project

Subject Terms: chronic illnesses; Clusters; older adults

Geographic Coverage: Southeastern USA

Time Period(s): 1/1/2015 – 12/31/2015 (Patients assigned to the Medicare Shared Savings Program for all 4 quarters of 2015)

Collection Date(s): 1990 – 2015 (Includes retrospective review of records through 2015)

Universe: All Medicare adults aged 27 and older assigned to the Shared Savings Program and for whom medical records were available, N=44,645

Data Type(s): administrative records data; clinical data; medical records

Collection Notes: Data categorized to protect patient confidentiality

Methodology

Response Rate: In total, 95% of Medicare Beneficiaries assigned to the Shared Savings Program in all 4 quarters of the 2015 calendar year are included in the analysis cohort. Omissions were due to: inability to link patient to the demographic data file (3.6%); patient < 27 years of age (0.24%); inability to link assigned patient to the medical records database (0.88%); lack of any diagnostic data for patient in the medical records (0.27%)

Sampling: No sampling was used. The analysis cohort was comprised of all MSSP members, ages 27 and older, with linked medical record information.

Data Source: Centers for Medicare and Medicaid (CMS) for Beneficiary assignment and claims
Electronic Health Records for diagnostic and clinical data

Collection Mode(s): record abstracts

Scales: Chronic Conditions were classified from ICD-9-CM and ICD-10-CM codes using the definitions in Elixhauser Comorbid Conditions (31 conditions), selected Charlson Comorbid Conditions (Myocardial Infarction, Cerebrovascular disease, Dementia), and
Clinical Classifications System (CCS) for Coronary Disease, Lipid Metabolism Disorders, Osteoarthritis.
References:
Quan H, Sundaraarajan V, Halfon P, et al. Medical Care, 2005, 43 (11):1130-1139.
www,hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jcp

Weights: None

Unit(s) of Observation: Individuals

Geographic Unit: Patients

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Published Versions

V1 [2019-06-04]

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