Illness severity and total visits in family medicine

Journal of Evaluation in Clinical Practice
James E RohrerSteven C Adamson

Abstract

The purpose of this study was to estimate the independent effect of clinical severity on visit utilization by family medicine patients so that disease management programmes can be targeted accurately and immediately towards patients most likely to benefit from them. A convenience sample of 698 primary care patients was analysed. All patients had been referred to a medical specialist. Utilization of all types of medical services including laboratory, radiology and ancillary services was used to classify patients as high-utilizers (the top 20%) or not high-utilizers. Patients were stratified into three severity categories based on point scores assigned to specific diseases. The diagnoses included in the Charlson severity index were used to score each patient and the Charlson point scores were used to measure severity. The odds of being a high-utilizer were adjusted for severity category and demographic variables. Severity was independently related to the odds of being a high-user (adjusted odds ratio = 2.7 for severity = 1 and 5.7 for severity = 2, with the reference category being severity = 0). Age was related to high-use in univariate analyses but not in multivariate analyses. Case management programmes in primary care practic...Continue Reading

References

Nov 1, 1991·The Journal of Nervous and Mental Disease·L J Kirmayer, J M Robbins
Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Mar 11, 2004·Journal of General Internal Medicine·Lisa R ShugarmanJoanne Lynn
Jul 3, 2004·Stroke; a Journal of Cerebral Circulation·Larry B GoldsteinRonnie D Horner
May 24, 2005·Medical Care·Saima ChaudhryDavid Meltzer
Jun 22, 2005·Disease Management : DM·Karen E BrownWilliam H Sledge
Jul 28, 2005·Annals of Family Medicine·James M NaessensClaudia R Campbell
Aug 3, 2005·Archives of General Psychiatry·Arthur J BarskyDavid W Bates
Oct 7, 2005·Arthritis and Rheumatism·Kelli L DominickHayden B Bosworth
Mar 4, 2006·The Clinical Journal of Pain·Patricia L DobkinMaida J Sewitch
Apr 20, 2006·Disease Management : DM·Ariel LindenNancy Roberts
May 3, 2006·The Psychiatric Clinics of North America·Jonathan S Abramowitz, Autumn E Braddock

❮ Previous
Next ❯

Citations

Jul 14, 2012·Population Health Management·Kurt B AngstmanKathy L Maclaughlin
Sep 6, 2014·SpringerPlus·Abdur Razzaque SarkerJahangir Am Khan
Jul 1, 2008·The Patient·James E RohrerKurt B Angstman
Oct 24, 2008·Population Health Management·James E RohrerSteven C Adamson
Jan 17, 2009·Quality Management in Health Care·James E RohrerJoseph W Furst
Aug 12, 2009·The Health Care Manager·Kurt B AngstmanRajeev Chaudhry
Jul 30, 2021·Health Science Reports·Shelley-Ann M GirwarMarc A Bruijnzeels

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.