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

Version
1
Resource Type
Dataset : administrative records data, clinical data, medical records
Creator
  • Egan, Brent (University of South Carolina, School of Medicine-Greenville)
  • Sutherland, Susan (University of South Carolina School of Medicine-Greenville)
Publication Date
2019-01-01
Funding Reference
  • None
Free Keywords
chronic illnesses; Clusters; older adults
Description
  • Abstract

    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.
  • Weighting

    None
  • Technical Information

    Response Rates: 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%)
  • Technical Information

    Presence of Common 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

Temporal Coverage
  • 2015-01-01 / 2015-12-31
    Time Period: Thu Jan 01 00:00:00 EST 2015--Thu Dec 31 00:00:00 EST 2015 (Patients assigned to the Medicare Shared Savings Program for all 4 quarters of 2015)
  • 1990-01-01 / 2015-12-31
    Collection Date(s): Mon Jan 01 00:00:00 EST 1990--Thu Dec 31 00:00:00 EST 2015 (Includes retrospective review of records through 2015)
Geographic Coverage
  • Southeastern USA
Sampled Universe
All Medicare adults aged 27 and older assigned to the Shared Savings Program and for whom medical records were available, N=44,645  Smallest Geographic Unit: Patients
Sampling
No sampling was used. The analysis cohort was comprised of all MSSP members, ages 27 and older, with linked medical record information.
Collection Mode
  • record abstracts~~

    Data categorized to protect patient confidentiality

Availability
Download

Update Metadata: 2019-06-04 | Issue Number: 1 | Registration Date: 2019-06-04

Egan, Brent; Sutherland, Susan (2019): Cluster-Based Approach for Integrating Clinical Management of Multiple Chronic Conditions. Version: 1. ICPSR - Interuniversity Consortium for Political and Social Research. Dataset. https://doi.org/10.3886/E109150V1