Identifying multimorbid patients with high care needs - A study based on electronic medical record data

Figures & data

Table 1. Demographics, health related characteristics and health service use of persons with multimorbidity in 2012 (n = 245.065).

			High needs subgroups
	ALL		GP		ED		Hosp
	n	%	n	%	n	%	n	%
Age
18–49	50,944	21%	3,578	14%	5,117	17%	2,075	13%
50–64	75,440	31%	5,639	22%	7,542	25%	3,373	20%
65–74	59,102	24%	5,713	22%	6,993	23%	3,851	23%
75–84	42,489	17%	6,835	26%	7,076	23%	4,572	28%
85 and older	17,090	7%	4,415	17%	3,678	12%	2,616	16%
Sex
Male	104,257	43%	8,639	33%	13,513	44%	7,561	46%
Female	140,808	57%	17,541	67%	16,875	56%	8,926	54%
No. chronic diseases in 2011–2012
2	110,535	45%	6,232	24%	10,177	33%	5,066	31%
3	62,559	26%	6,014	23%	7,500	25%	3,958	24%
4	34,563	14%	4,763	18%	5,021	17%	2,830	17%
≥5	37,408	15%	9,080	35%	7,690	25%	4,633	28%
Psychological symptoms/disease in 2011–2012*	48,650	20%	6,727	26%	6,522	21%	3,080	19%
No. different medications prescribed in 2012**
0	6,857	3%	99	0.4%	495	2%	216	1%
1	13,896	6%	341	1%	1,007	3%	441	3%
2	20,546	8%	601	2%	1,524	5%	714	4%
3	24,821	10%	1,008	4%	1,988	7%	954	6%
4	26,379	11%	1,311	5%	2,227	7%	1,151	7%
≥5	152,566	62%	22,820	87%	23,147	76%	13,011	79%
Psychotropic drugs prescribed in 2012	71,452	29%	11,901	45%	10,969	36%	5,782	35%
No. contacts with general practice in 2012
0	14,315	6%	145	1%	1,217	4%	650	4%
1–2	49,641	20%	977	4%	4,447	15%	2,367	14%
3–5	76,529	31%	3,214	12%	8,163	27%	4,373	27%
6–8	49,960	20%	4,805	18%	6,517	21%	3,531	21%
9–11	25,554	10%	4,766	18%	3,938	13%	2,158	13%
≥12	29,066	12%	12,273	47%	6,016	20%	3,408	21%

ALL: all patients with multimorbidity (≥2 chronic diseases); GP: patients with multimorbidity and ≥12 GP contacts; ED: patients with multimorbidity with ≥1 visits to the emergency department; HOSP: patients with multimorbidity with ≥ hospitalisations.

*ICPC code from chapter P.

**on ATC-3 level.

Table 2. Use of health services in persons with multimorbidity in 2013.

	n	%
No. GP contacts
0	21.423	9%
1–2	55.087	22%
3–5	74.133	30%
6–8	44.992	18%
9–11	23.250	9%
≥ 12	26.180	11%
ED visits*
0	214.677	88%
1	19.624	8%
> 1	10.764	4%
Unplanned hospitalisations**
0	228.578	93%
1	13.615	6%
2	2.177	0.9%
≥ 3	695	0.3%

*Care activity 190015.

**Date hospital admission (care activity 190021) same as start date of DRG (diagnosis related groups).

Figure 1. Overlap of multimorbid patients with high number of contacts with general practice, emergency and unplanned hospitalisations.

Figure 2. (a) ROC curve of probit model to predict ≥12 GP contacts; (b) ROC curve of probit model to predict an ED visit; (c) ROC curve of probit model to predict an unplanned hospitalisation.