Identification of case complexity and increased health care utilization in patients with rheumatoid arthritis.

Details

Serval ID
serval:BIB_0C13EA7ED480
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Identification of case complexity and increased health care utilization in patients with rheumatoid arthritis.
Journal
Arthritis and rheumatism
Author(s)
Koch N., Stiefel F., de Jonge P., Fransen J., Chamot A.M., Gerster J.C., Huyse F., So A.K.
ISSN
0004-3591
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
45
Number
3
Pages
216-21
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
OBJECTIVES: To document biopsychosocial profiles of patients with rheumatoid arthritis (RA) by means of the INTERMED and to correlate the results with conventional methods of disease assessment and health care utilization. METHODS: Patients with RA (n = 75) were evaluated with the INTERMED, an instrument for assessing case complexity and care needs. Based on their INTERMED scores, patients were compared with regard to severity of illness, functional status, and health care utilization. RESULTS: In cluster analysis, a 2-cluster solution emerged, with about half of the patients characterized as complex. Complex patients scoring especially high in the psychosocial domain of the INTERMED were disabled significantly more often and took more psychotropic drugs. Although the 2 patient groups did not differ in severity of illness and functional status, complex patients rated their illness as more severe on subjective measures and on most items of the Medical Outcomes Study Short Form 36. Complex patients showed increased health care utilization despite a similar biologic profile. CONCLUSIONS: The INTERMED identified complex patients with increased health care utilization, provided meaningful and comprehensive patient information, and proved to be easy to implement and advantageous compared with conventional methods of disease assessment. Intervention studies will have to demonstrate whether management strategies based on INTERMED profiles can improve treatment response and outcome of complex patients.
Keywords
Adult, Aged, Arthritis, Rheumatoid, Cluster Analysis, Delivery of Health Care, Female, Humans, Male, Middle Aged, Severity of Illness Index
Pubmed
Web of science
Create date
25/01/2008 8:38
Last modification date
01/03/2020 22:17
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